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WdiI^triaii Hygiene 




NURSING 

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WMPMPMI 



NEW MAVEN, '. 'NN 




LIBRARY OF 

THE SCHOOL OF 

NURSING 



The American Health Primers. 

EDITED BY W. W. KEEN, M. D., 
Fellow of the College of Physicians of Philadelphia. 

This series of American Health Primers is prepared to diffuse as widely ano 
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Preventive Medicine, and the bearings and applications of the latest and best re 
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HEARING, AND HOW TO KEEP IT. With Illustrations. By Chas. H. 

Burnett, M. D., Aurist to the Presbyterian Hospital, Professor in the Philadel 

phia Polyclinic. 
LONG LIFE, AND HOW TO REACH IT. By J. G. Richardson, M. D , 

Piofessor of Hygiene in the University of Pennsylvania. 
THE SUMMER, AND ITS DISEASES. By James C. Wilson, M. D. v 

Lecturer on Physical Diagnosis in Jefferson Medical College. 
EYESIGHT, AND HOW TO CARE FOR IT. With Illustrations. By 

Geo C. Harlan, M. D., Surgeon to the Wills (Eye) Hospital, and to the Eye 

and Ear Department, Pennsylvania Hospital. 

THE THROAT AND THE VOICE. With Illustrations. By J. Solis Co- 

hen, M. D., Lecturer on Diseases of the Throat in Jefferson Medical College. 
Philadelphia, etc. 

THE WINTER, AND ITS DANGERS. By Hamilton Osgood, M. D.. 

of Boston, Editorial Staff Boston Medical and Surgical Journal. 

THE MOUTH AND THE TEETH. With Illustrations. By J. W. Whitb . 

M. D., D. D. S., of Philadelphia, Editor of the Denial Cosmos. 
BRAIN WORK AND OVERWORK. By K. C.Wood. Jr., M. D., Clin 

ical Professor of Nervous Diseases in the University of Pennsylvania. 
OUR HOMES. With Illustrations. By Henry Hartshorne, M. D.,of Phil 

adelphia, formerly Professor of Hygiene in the University of Pennsylvania. 
THE SKIN IN HEALTH AND DISEASE. By L. D. Bulkley, M. D.. 01 

Yew York, Physician to the Skin Department of the Demilt Dispensary and oi 

the New York Hospital. 
SEA AIR AND SEA BATHING. By John H. Packard, M. D., of Phila 

delphia. Surgeon to the Pensylvania and to St. Joseph's Hospitals. 
SCHOOL AND INDUSTRIAL HYGIENE. By D. F. Lincoln, M. D., oi 

Boston, Chairman Department of Health, American Social Science Association 

" Each Volume of the 'American Health Primers" The Inter-Ocean has had the 
pleasure to commend. In their practical teachings, learning, and sound sense, 
the^e volumes are worthy of all the compliments they have received. They teach 
what every man and woman should know, and yet what nine-tenths of the intelligent 
classes are ignorant of, or at best, have a scattering knowledge of." — Chicago Inter 
Ocean. 

" The series of American Health Primers deserves hearty commendation. These 
handbook* of practical suggestion are prepared by men whose professional compe- 
tence is beyond question, and for the most part, by those who have made the sub- 
ject treated the specific study of their lives." 



School and Industrial 



Hygiene. 



BY 

D. F. LINCOLN, M.D., 

Chairman Department of Health, Social Science Association. 



PHILADELPHIA: 
P. BLAKISTON, SON & CO., 

No. IOI2 WALNUT STREET. 
1896. 



Copyright. 

PRESLEY BLAKISTON. 

18 So. 




CONTENTS. 



PART I.— SCHOOL HYGIENE. 

PAGB 
CHAPTER. 

I. — General Remarks 7 

II. — Emotional and Mental Strain . . 14 

III. — Food and Sleep . . . • • • '9 

IV. — Bodily Growth 2 4 

V. — Amount of Study 28 

VI. — Exercise 34 

VII. — Care of the Eyes . . . . • 4 8 
VIII. — School-Desks and Seats . . . -64 

IX. — A Model School-Room . . . .79 
X. Ventilation and Heating . . .85 

XL — Site, Drainage, etc 94 

1* v 



VI CONTENTS. 

CHAPTER. PAGE 

XII. — Private Schools 98 

XIII. — Colleges 102 

XIV. — Contagious Disease 105 

PART II.— INDUSTRIAL HYGIENE. 

I. — Injurious Effects of Inhaling Dusty 

and Poisonous Substances . . . 107 

II. — Injuries from Atmospheric Changes . 120 

III. — Injuries from Over-Use of Certain Or- 
gans 127 

IV. — Injuries from Accidents . . . -133 

V. — Regulation of Hours of Labor . .136 

VI. — Duration of Life in Various Occupa- 
tions 142 

Note 145 

Index 146 



School and Industrial Hygiene. 



PART I. 
SCHOOL HYGIENE. 



CHAPTER I. 

GENERAL REMARKS. 



THE period at which we live is witnessing great 
changes in the theory and practice of education, 
from the lowest to the highest grades. The nature 
of the child's mind has been studied, his powers 
gauged, and his growth measured by a Pestalozzi, a 
Froebel, a Combe, a Chadwick, a Bowditch. Every- 
body knows that children do not like to sit still long 
at a time ; that their minds easily wander ; that they 
have an instinctive dislike to certain studies. This 
restlessness of mind and body, this dislike to certain 
mental foods, were regarded by the old masters as 
simply undesirable elements in character, to be 
curbed and chained, and overcome by force of dis- 

7 



8 SCHOOL AND INDUSTRIAL HYGIENE. 

cipline. The modern tendency is in a very different 
direction ; it studies the natural behavior of chil- 
dren, and deduces from multiplied observations cer- 
tain laws regarding their natural powers and apti- 
tudes, to which all educational processes are subor- 
dinated. 

To some extent the old masters were right; curbs 
have their use, and " old-fashioned " hard work ought 
not to be forgotten. Nor is the newer education free 
from grave faults of its own ; or let us rather say, 
that right principles are not yet fully adopted by all. 
A great many teachers have found that emulation is 
a more than effectual substitute for the rod. This is 
one of the most characteristic of modern improve- 
ments ; but its potency has no sooner been discov- 
ered than it is abused, and many a promising child, 
within the past thirty years, has wrecked his physi- 
cal endurance for life, or has permanently enfeebled 
his mind by excess of study performed under the spur 
of emulation or an unregulated sense of duty. 

No theory of education is satisfactory thst does 
not claim the whole child. The State must leave a 
great many things to the parents in education ; but 
it is her duty to attend to such things as parents can- 
not be made to attend to. Religion is a thing which 
the State does not try to teach, assuming that parents 
and churches can more safely attend to it ; but mo- 
rality must be taught at school. All schools assume 



GENERAL REMARKS. g 

the immorality of falsehood and brutality, and the 
paramount obligation to perform school-tasks. It 
would be easy to take classes of ignorant, poor chil- 
dren, before they reach the age of street ruffians 
(which so many become after leaving the public 
school), and not only to show them, but to convince 
them of the necessity for truth, peaceable behavior, 
and respect for law, and of the necessary connection 
between duty or work performed and the prosperity 
of one and all.* In our public schools, I think this 
is hardly attempted. And yet, setting aside the 
moral, and assuming the sanitarian, ground as our 
sole basis, it is assuredly true that these branches of 
morals, and others that might be named, as punctu- 
ality, cleanliness, politeness, and faithfulness to en- 
gagements, are not things which can be neglected. 

Again : the food and sleep of the child are mainly 
beyond the control of public schools. They are not 
wholly so, however; and it is a teacher's duty to 
discourage working in improper hours. Still more 
imperatively is it his duty to regulate the child's 
needs in school-time, to see if he is faint from want 
of food,- to encourage and teach good habits, and to 
give opportunity for bodily exercise. 

No lower aim should content the child's teacher 
than that of improving all his faculties and powers — 

* For admirable illustrations of this kind of teaching, see 
George Combe's " Education," edited by Wm. Jolly, 1879. 



IO SCHOOL AND INDUSTRIAL HYGIENE. 

bodily, mental, and moral. The teacher should feel 
his obligation to his school a patriotic one, as 
did the Athenian office-holder, who swore, " a^iva 
rtapaiaoeiv," to transmit the city over which he ruled 
better than when it was put into his hands ; better in 
all respects. 

It is my strong conviction that this can be done 
by the public or the State to a greater extent than is 
now accomplished. 

The word "culture" is as badly abused to-day as 
the word " sentiment " was a century ago. For vast 
numbers of our people, the pursuit of culture resolves 
itself into the reading of books and the looking at 
pictures and bric-a-brac for the purpose of talking 
about them. We can easily widen this notion. The 
culture (or development) of children certainly means 
something better than this. But how much wider 
and better ? It is preposterous to educate all children 
in all branches of knowledge. We are already trying 
to do too much in that direction ; but it is equally 
preposterous to omit from culture the development of 
physical endurance, moral soundness, and a good 
practical judgment. In the case of myriads of poor 
children who leave school at the ages of ten or 
twelve, the opportunities for doing this are indeed 
limited — and are made so by our absurd practice of 
making excessively large classes ; but the State should 
never lose from mind the object of training these 



GENERAL REMARKS. I I 

children up to men and women. As regards those 
whose education is superior and protracted, there is 
a full opportunity for developing power and self-con- 
trol. How do we give a young man power to fight his 
way in the world ? We put him into a school which 
teaches only the brain, and only a corner of that. 
When he is thirty years old, he will, assuredly, not 
be groaning that his tutors gave him but too imperfect 
an acquaintance with the Greek lyrists, or Visigothic 
numismatology; he will probably be wondering (if 
he is an active American) whether it pays to know 
all that ; and at forty he will have discovered that 
the one thing which does pay in this life is life itself; 
that vital force and endurance and a good digestion 
are what are needed, as much as anything from books, 
to insure success in life. The President of Harvard 
College states this more strongly still. 

The element of self-control and guidance, in cul- 
ture, is quite as much a moral as an intellectual one. 
The boy is taught how to control his hand in writing 
or playing, his voice in speaking or singing, his 
organ of language in writing theses. He is not so 
taught in regard to the use of his moral faculties, his 
affections, emotions, and passions ; nor is he shown 
how a want of self-control, whether in the form of 
caprice, indolence, good-nature, affection, or ambi- 
tion, or even when veiled under the aspect of duty, 
may take away the half of the value of his talents 



12 SCHOOL AND INDUSTRIAL HYGIENE. 

and knowledge. Perhaps these remarks would be 
more forcible if applied to girls and young women, 
in whom self-restraint is not commonly thought a 
necessity, and the feelings naturally take the place of 
reflection. 

All that can be said against over-study must be re- 
versed when we speak of moderate and rational study. 
Overwork ought not to be allowed, on the one hand ; 
and on the other, indolence must not be permitted. 
It is little to say that study ought not to be allowed 
to injure the health. We may say much more : it is 
capable of improving health ; and for many persons 
it is an indispensable means of health. A child who 
has been kept at suitable tasks unconsciously misses 
them when they come to an end. Civilized and 
reading beings (I assume that a civilized, awakened, 
informed, and interested mind is a desideratum !) must 
have something for the mind to work upon, or they 
fret themselves with ennui. Much study may be a 
weariness to the flesh ; it may give dyspepsia by being 
allowed to encroach on physical duties ; but when a 
person has learned to hold the proper proportion be- 
tween these two, there is nothing that he finds more 
conducive to peace, satisfaction, and comfort. This 
pleasant result always follows when one has accom- 
plished work which he is fitted for ; and to deny an 
individual his intellectual exercise is as truly a dam- 
age to the body as is the deprivation of physical ex- 



GENERAL REMARKS. I 3 

ercise. For want of accustomed mental stimulus and 
work, many a man (it is an old story) has found that 
his retirement from active business was his death- 
warrant. 

School-life, however, seems to have some injurious 
effects on the health and growth of some children. 
Very often it is not the school that injures a child, 
but the fact that the child is living in a city and has 
no place to run out-of-doors. Very often it is not 
study at all that hurts, but study in hot or close or 
badly-lighted rooms ; or study may be in excess of 
the powers of the system. Such points as these will 
receive our present attention. 



CHAPTER II. 

EMOTIONAL AND MENTAL STRAIN. 

EMOTIONAL STKAIN.— Teachers are fully aware 
that this is a fluctuating factor in each child, de- 
pendent on the weather, fatigue, excitement, and 
other circumstances. 

Of these circumstances, those which affect the 
equilibrium of power are among the most import- 
ant. There is a large class of irregular mental or 
emotional states which are unfavorable to the com- 
plete health and steady activity of the mind. The so- 
called depressing emotions — timidity, despondency, 
anxiety, and discontent — often interfere with the 
mental health, producing actual and very marked 
lowering of the powers of execution. No scholar 
ought to be allowed to remain under the influence of 
them. It is the teacher's place to find out the cause, 
and remove it if possible. In a certain number of 
cases, they may be due to unkindness or neglect com- 
ing from the teacher or the playmates. A neglect to 
award merited praise either wounds or hardens the 
one who feels the injustice. Again, all these de- 

14 



EMOTIONAL AND MENTAL STRAIN. 1 5 

pressed states may be simply a sign of over-work, 
want of exercise, bad air, want of sleep or food, 
etc. 

A child must not be spared all that is irksome. 
Quite the contrary of this, the performance of irk- 
some duty is one of the best lessons taught in school. 
But it is undesirable that he should feel the object 
of his study a worthless one, or should find his best 
efforts unsuccessful. I venture to suggest that, in 
these respects, the teacher needs as much of our 
sympathy as the scholar. Too much drudgery is 
laid upon her in correcting exercises, looking over 
examination books and papers, making up averages 
of marks, weekly and monthly reports, and other 
"school statistics." It is hard and unsatisfactory to 
have to give hours of the time needed for mental re- 
freshment to the production of a few numerical re- 
sults, which are probably destined to lie idle on a 
shelf. 

Mental Strain. — There is a great deal of harm 
done by excessive urging or over-driving of children 
in school, as the reader must be aware. Yet, on the 
other hand, there are many scholars whose natures 
need this urging, and are not properly developed with- 
out it. If a given degree of "pressure" seems to 
the teacher's judgment moderate, how shall it be 
decided to be e<tessive by persons who are not wit- 
nesses ? Who is a better judge than the teacher of 



l6 SCHOOL AND INDUSTRIAL HYGIENE. 

what constitutes a fair amount of work ? In reply, it 
should be said that a parent knows more about a 
child, in the generality of cases, than a teacher.* 
It is a parent's eye that can best see when the child 
is "unlike himself;" and the parent is justified in 
feeling anxiety whenever the child loses sleep and 
the desire for food and play. 

The means by which children are urged are well 
known, consisting of credits, rank, prizes, public ex- 
hibitions, and the moral influence of a teacher of 
strenuous disposition. It will not do to condemn 
all of these at once, for they have arguments in their 
favor. But, as a general thing, the giving of prizes, 
or at least public displays upon the stage, may safely 
be forbidden in the case of girls as useless, if not 
harmful. Their nervous system responds too quickly 
to such stimuli. 

If there be novels which do harm " by giving false 
views of life," are there not schools for girls which 
do precisely the same thing, by the excessive im- 
portance which they allow the pupils to attach to a 
paltry gift, or, far worse, to success in beating 
rivals ? 

The scholar's future health cannot but be bene- 
fited by an effort to conquer indolence ; but — to re- 
turn to our chief point — children ought in some cases 

* Especially if the child be one among fitty-six, who remain 
only five months with one teacher. 



EMOTIONAL AND MENTAL STRAIN. \-J 

to be allowed to seem indolent, for reasons elsewhere 
indicated ; and it is palpably unsafe to subject all 
scholars to an equal pressure. 

"Over-driven" children will often study late and 
sleep poorly ; they then rise late, dress in haste, and 
rush for school in dread of a mark for tardiness, often 
not pausing to sit down at the breakfast-table. They 
thus enter on the day's work with an exhausted and 
irritable system, which does not have a chance during 
the forenoon — so taken up is it with school-thoughts — 
to remember its need for repair and rest. The lunch- 
eon-basket probably contains food suited to attract 
a jaded system and to produce dyspepsia — cake and 
pie and doughnuts. The child finishes the school- 
tasks, and goes home with an armful of books and an 
aching head — in need of food and rest and play, but 
hardly aware of either, and intent simply on learning 
the next day's lessons. There is no recovery from 
this strain, for the lessons are not learned until bed- 
time, when the experience of the day before is re- 
peated, and so on day after day until the fixed term 
expires. 

This over-work is unfortunately apt to occur at the 
very time of the year when the system is least able to 
bear it. The "exhibitions," the closing examina- 
tions, and the stress of the struggle for prizes, come 
in the months of April, May, and June, when the 
body craves fresh air and the eyes long for green 
2* B 



1 8 SCHOOL AND INDUSTRIAL HYGIENE. 

fields ; when, too, the powers of the system begin to 
flag from the withdrawal of the stimulus of cold, 
which has kept them strung up to a higher pitch all 
the winter. This constitutes a very serious objection 
to the present system of school-exhibitions. It is 
needless to say that teachers are not exempt from this 
strain. 



CHAPTER III. 

FOOD AND SLEEP. 

THIS is the place to finish what needs to be said 
regarding food and sleep. 
The logical connection is quite obvious. Study is 
a consuming of certain materials contained in the 
brain and the blood ; food and sleep are the means 
by which this loss is made good, and the mind placed 
in a fit condition to resume work. The system of a 
child who is studying to excess is becoming exhausted ; 
it loses its powers in various directions ; the muscu- 
lar endurance may be enfeebled ; the digestion is very 
apt to fail ; appetite for food is lost, with the power 
to digest food; and sleep is very apt to be poor. It 
is pretty safe to say that a child who eats and sleeps 
well is not much over-driven. There is a natural 
antagonism between active study and active digestion. 
A nourishing meal indisposes a healthy person to ac- 
tive mental exertion ; and, vice versd, active study or 
mental excitement takes away appetite, or at least 
enfeebles the digestive power for a time. What we 
say of hard study is equally true of hard play. After 

«9 



20 SCHOOL AND INDUSTRIAL HYGIENE. 

hard study or play there should be an interval for 
relaxation or cooling-down before a meal is eaten. 
Nothing could be more injudicious than a programme 
which allows only one hour for dinner, following a 
forenoon of study, and followed by an afternoon of 
study. If it be thought desirable for young adults to 
make the day as full as possible, it will be much better 
to have an intermission of two hours at noon-time. 
And persons not adults should always obey a rule 
which places an hour's interval between dinner and 
study, and at least half an hour between breakfast 
or tea and study. All the meals must be nourishing, 
and stimulants, such as tea, or coffee in particular, 
should form no part of them. If the proper amount 
of sleep is had, there is very little time for study in 
the evening. The child should sleep ten hours at 
the age of twelve years; nine hours at the age of 
fourteen or fifteen ; and eight hours at the age of 
seventeen or eighteen. It is not necessary that he 
should indulge in the habit (salutary for many adults) 
of taking a nap after meals. 

At the "Smith College," at Northampton, Mass., 
the young ladies are expected to be in bed at ten 
o'clock, and are strongly advised not to rise before 
six o'clock. The students are of the usual "college 
age," say from eighteen to twenty-one. 

Study or exercise before breakfast is not generally 
to be allowed ; it will do harm to many children. 



FOOD AND SLEEP. 21 

Excessively long intervals between meals are of 
course to be avoided, or to be broken by solid lunch- 
eons. If the above amount of sleep be allowed, 
there will not be time for more than three regular 
meals and a lunch. 

Late dinners are apt to interfere with children's 
sleep ; if, for instance, the family meal is from six to 
seven, and the children go to bed from eight to nine. 
A hearty, comfortable dinner about the noon-time is 
much better. It is perfectly true that the afternoon 
session is likely to be rather a sleepy one ; this should 
induce the judicious teacher to shorten the session, 
and to pl%fer manual tasks (writing, drawing, etc.) 
rather than those that call for thought. Afternoon 
lessons add very little tothechild'sstock of knowledge. 

Is there an antagonism between food and study? 
Is the mind paralyzed by the contact with the gross 
material aliment ? If it be so, why not make the 
practical inference, and reduce the amount of food in 
order to study better? This proposition, insane as 
it looks to one who understands the physiological law 
of our living, is no doubt seriously acted upon by 
many ambitious scholars. To such I would say — 
though with small hope of being heard — that it is no 
disgrace to the mind that it is attached to a body. 
Its Creator has willed it so, and for this life it must be 
so. To give a body insufficient food, and to exact 
a full task from the brain, is slow suicide. The nour- 



22 SCHOOL AND INDUSTRIAL HYGIENE. 

ishment goes to the brain, while the rest of the body 
grows puny, and the foundation of slow diseases, 
such as consumption, is often laid. True, there have 
been men and women with whom sedentary habits 
and a spare diet have agreed perfectly ; but with most 
men and women the result is dyspepsia, melancholy, 
and a tendency to consumption or insanity ; and as 
to children, or persons under twenty, a sedentary life 
with spare diet is a pure absurdity. There are telling 
maxims, indeed, insisting that we should rescue hours 
from the night and add them to our lives, and com- 
paring sleep to death : 

" Stulte, quid est somnus, gelidse nisi mortis imago ?" 

but, before you acknowledge their force, go and look 
at the sleep of a healthy child. If you are alarmed 
at being drowsy after eating, recollect that the bright- 
est fire is dulled for a little while after fuel is put on. 

In connection with institutions for large boys and 
girls, — "colleges, ' ' as they are sometimes called, — it 
may be desirable to establish a cheap lunch-counter, 
which furnishes an inducement to eat solid and whole- 
some food rather than a stale mess brought from 
homes at great distances. 

Americans, in general, eat a great deal of trash. 
They are brought up to it. The subject is rather a 
wide one, but it may be of service to indicate what 
is not trash: A plenty of roast and less of boiled 



FOOD AND SLEEP. 2$ 

meat; a few soups made secundum artem; a fair va- 
riety of plain vegetables ; an occasional treat of the 
best fruit, with abundant supplies of apples ; good 
bread of more than one sort ; a daily and abundant 
ration of the simplest and most strengthening food, 
such as oatmeal or Indian-meal mush, with milk; 
and, for drinks, water, milk, coffee which contains as 
little of the original bean as possible, tea that is not 
too strong, or diluted cocoa. Such a dietary, without 
the compounds commonly used for dessert, but aided 
by fresh air, sunlight, and plenty of play, makes 
healthy children. Fish and eggs and milk are also 
necessary, but should not be eaten under the impres- 
sion that they " make brain." 

The boarding-schools of our country have a great 
opportunity for implanting habits of simple and whole- 
some living. If such schools furnish unwholesome 
diet, they do it in imitation of the ordinary habits 
of society. In a well-conducted school, on the other 
hand, — where enough of the best and simplest is 
given, — it is not uncommon for pupils to come from 
the indulgences of home and holidays dyspeptic and 
flabby, and to become brighter and stronger as soon 
as they are subjected to the regimen of school. 



CHAPTER IV. 

BODILY GROWTH. 

IF youth be a formative period, whose product is 
simply the adult person, then, surely, that period 
v/hen formation is most rapid, — when a new being 
par excellence is developing, — deserves the greatest 
respect and care. In the case of boys, growth goes 
on at a nearly uniform rate until manhood. Girls, 
however, concentrate a great deal of growth in a 
few years. They are shorter and weigh less than 
boys until the age of eleven or twelve, when they 
suddenly shoot beyond them, and, for about three 
years, continue decidedly taller and heavier, after 
which they resume the former relative position.* It 
would seem reasonable to suppose that girls at this 
age are less capable of mental application than boys; 
for it is a general rule of Nature, that when a great 
demand is made on the system by one set of func- 
tions others must remain in comparative abeyance, 

* Prof. H. P. Bowditch, in " Eighth Annual Report of Mas- 
sachusetts State Board of Health." 

24 



BODILY GROWTH. 2% 

and that when growth is very rapid, mental action is 
proportionally less so. If girls are often found 
quicker and brighter than boys at this age, it may, 
nevertheless, be questioned whether it is right to 
allow them to come in competition with boys ; for 
pluck and vivacity are not, necessarily, evidence of 
power. 

After this age — that is, about fourteen and fifteen, 
in most cases — comes the time when girls are under- 
going a change which affects the whole system in a 
different way from mere rapidityof growth, — achange 
which, if effected quietly and normally, may be said 
to have laid the foundation of the happiness and 
health of an entire life. At this period, if at no 
other, a girl should be protected from the excitement 
of "society" and late hours, and should receive the 
support and steadying which regular habits of study 
impart. It is a more directly practical thing to say 
that she ought to be treated with leniency at certain 
times; her work should be lightened, her errors ex- 
cused, her inattention or unreadiness overlooked, and 
absence from school allowed if requested. 

Many young girls have grown up to be strong and 
useful women, and have never been aware that their 
mental powers were less under control than those of 
boys of their own age, — their school-fellows, — or that 
there was any physical necessity for their studying less 
than, or differently from, their brothers. Especially 
3 



26 SCHOOL AND INDUSTRIAL HYGIENE. 

is this true of country girls brought up without the 
excitements of society. 

The late Dr. E. H. Clarke, of Boston, was of the 
opinion that our system of public school education 
was ruining the health of vast numbers of young 
women, by compelling them to study to excess, par- 
ticularly at the monthly period. His opinion was 
vigorously stated in a little book, published a few 
years since, entitled "Sex in Education." Equally 
vigorous counter-statements were made in the books 
called "Sex and Education," "No Sex in Educa- 
tion," "The Education of American Girls," and 
in other places; and quite a salutary storm arose, 
which has resulted, it may be hoped, in leaving the 
public impressed with the importance of the subject, 
if nothing more. 

I would here refer the reader to two of the follow- 
ing chapters — that on Amount of Study and that on 
Exercise. It seems to me fair to say that the growing 
girl would hot generally suffer from her studies if 
they were restricted within the limits hereafter sug- 
gested, and if her physical development were cared 
for properly. A healthy girl — such as nine out of 
ten ought to be — need not suffer in health from reg- 
ular attendance on school for three or four or five 
hours a day, ;/ she is protected from "society" and 
given a fair chance to grow strong. The harm is 
done when a girl goes to the theatre or concert, and 



BODILY GROWTH. 2"J 

appears the next morning in school with a worn and 
tired look and two great circles around her eyes. 
The harm, indeed, is done long before, when she 
first comes to live in a city where public parks are 
thought unsafe for her to walk in, and where play in 
the open air (except for "children" — that is, very 
small girls) is an impossible or a forbidden thing. 
It begins with that substitution of artificial for natu- 
ral enjoyments, of society and its excitements for 
sports, of adult for childish interests, which is char- 
acteristic of city life. Many such girls are thought 
to be overworked if they lose their color, while study- 
ing four or five hours a day, at the age of fifteen. 



CHAPTER V. 

AMOUNT OF STUDY. 

EXCESS of mental application is any amount 
which interferes with the vegetative functions, 
i. e., anything which, by its intensity or long continu- 
ance, or by any peculiarity of its own, interferes with 
digestion, sleep, nutrition, repair, or development. 

As the reader is perfectly aware, the cell-structure 
called brain is in need of constant repair, equally 
with other structures; and this repair is effected by 
processes termed "vegetative." 

Muscles, stomach, and brain equally require vege- 
tative activity in order to keep them in condition ; 
and each may suffer from over-activity without im- 
pairing the health of the others. But, in general, 
overwork of one tells disadvantageously upon all, 
and an unsound or overburdened mind is apt to act 
like a burden upon the body. 

The amount of work to be assigned must be de- 
termined empirically, and we have no right to say of 
a given person, in advance of experience, that he is 
capable of doing a certain amount of work. But we 

28 



AMOUNT OF STUDY. 29 

can, as the result of experience, give an approximate 
statement of the amount which is suitable to the av- 
erage person at a given age. 

As has been said before, children can be aroused 
by modern methods to a great spontaneous activity 
of mind, which contrasts strongly with the listless 
and reluctant attention of old-fashioned schools. 
The effect is obtained by adapting the instruction to 
the child's capacity and nature. The kindergarten 
system is one of the most striking instances of this. 
I do not mention it either for praise or blame, but 
simply in order to point out the fact that, under the 
most favorable circumstances — cheerfulness, pleasant 
and varied tasks, sympathy, and wholesome surround- 
ings — a child at the kindergarten age has not the 
power to bear more than two or three hours of these 
tasks in a day consistently with health. If pursued 
longer, the work becomes too exciting. 

The late Mr. Edwin Chadwick, of England, is the 
chief authority for a definite statement of the num- 
ber of hours that a child should be allowed to do 
school-work. His statements are based on long and 
patient observation, and numerous inquiries made of 
teachers whose attention was especially called to the 
point ; and I do not think that any one has seriously 
attempted to refute his views, which were published 
a number of years ago. 

In the first place, he points out the obvious inabil- 
3* 



30 SCHOOL AND INDUSTRIAL HYGIENE. 

ity of the little child to pay attention for a length of 
time consecutively. The mind, like the body, must 
be in a continual change ; the efforts made must re- 
semble play in spontaneity, rapidity, and variety. 
Sedentary occupation is an enforced necessity with 
most adults, to some extent ; but it is always to be 
considered as involving possible danger, and for a 
little child is almost out of the question. His brain 
is imperfectly developed ; the power of attention is 
perfect, but incapable of sustained efforts ; the mind 
refuses to work long in one direction, as the body re- 
fuses to stand or sit still. There are certain classes 
of work which are utterly beyond his power ; and yet 
there is no doubt at all that a little child learns as 
much, if not more, in a year as an adult student. 
But he learns it in his own way, and it is not book 
knowledge. 

Let the adult reader try to attend to a new subject ; 
let him take, for example, a treatise on metaphysics, 
or anatomy, or vital statistics, or a "Student's Gib- 
bon," or some other work which demands close at- 
tention ; let the work be unfamiliar, not beyond his 
comprehension, not too interesting, and let him see 
how soon his mind begins to flag in the effort to 
master the text, as if it were a lesson to be recited. 
He will find, perhaps, at the end of an hour, not that 
the subject is merely uninteresting, but that his mind 
does not take hold of it as sharply as when he began ; 



AMOUNT OF STUDY. 3 I 

perhaps, if he is " tough," he can stand two hours. 
This, by the way, is quite a different thing from an 
irresponsible, leisurely reading of the brilliant narra- 
tion of a Parkman or a Froude. 

If an adult can apply himself to the acquisition of 
knowledge in one direction for only one hour (and 
how much longer can an audience listen to a lecture?), 
the child can evidently do very much less. At the age 
of from five to seven he can attend to one subject — a 
single lesson — for fifteen minutes ; a child from seven 
to ten years of age, about twenty minutes ; from ten to 
twelve years, about twenty- five minutes ; from twelve 
to sixteen or eighteen years, about thirty minutes. 
(Chad wick.) 

The total of daily work corresponds with the limits 
of a single effort. Ten hours' work is a maximum 
average for young men ; and there is a regular grad- 
ation from this down to two and a half or three hours 
for children under seven. 

The most vigorous and healthy young men are se- 
lected for West Point, and they are severely win- 
nowed by the work required of them. They are 
excluded from dissipation and general society ; their 
active bodily exercise, their regular diet and sleep, 
and the healthful climate of the place, leave nothing 
to be desired. They have ten hours a day for the six 
cold months ; in summer much less. In our colleges, 
where the students are not picked for their physique, 



32 SCHOOL AND INDUSTRIAL HYGIENE. 

the average actual work (study and recitation) among 
those who are faithful to their work will not probably 
exceed eight or nine hours, as far as my observation 
goes. 

In high-schools, during the period of rapid growth 
and sexual development, a lower figure must be as- 
sumed ; and it seems certain that five hours, or, under 
the most favorable circumstances, six, are all that 
should be required. The ages usually range from 
twelve to seventeen. 

Below the age of twelve years, four hours are prob- 
ably sufficient ; below ten years, three or three and a 
half; below seven years, two and a half or three 
hours. 

In England a very large number of children (over 
100,000, at my latest information) are sent to school 
on the so-called half-time plan. This plan is the 
result of an attempt by the Government to suppress 
the evils of juvenile labor in manufactories. The 
children attend school about three hours a day during 
the school-year, and those hours are taken out of 
their factory-time. It is found that children thus 
taught make as good progress as those who attend 
school six hours a day. This result is probably a 
mixed one, due, partly, to the beneficial effects of 
change of occupation, and partly to the fact that six 
hours are clearly beyond the limit of profitable men- 
tal exertion. Something must also be ascribed to the 



AMOUNT OF STUDY. 



33 



regularity of attendance in half-time schools, which 
is enforced under the penalty of exclusion from the 
factory.* 

At what age should a child be sent to school ? 
The kindergarten does not injure a child of four 
years unless carried to the point of over-excitement, 
which, I believe, is not often done. The common 
primary school, however, is decidedly objectionable. 
It takes very young children (six years of age), and 
compels them to remain twice as long as is good for 
them. By great ingenuity and vivacity, a teacher 
can keep them going upon various studies for three 
hours. This is all that is reasonably possible, yet 
the children are expected to come back for a second 
session in the afternoon. A school conducted by set 
lessons and recitations— a mimic grammar-school, in 
fact — should not receive children under seven or 
eight years of age. 

* See Reports of the Massachusetts Bureau of Labor for 

1871, 1875, and 1878. 

C 



CHAPTER VI. 

EXERCISE. 

IN spite of all that may be justly said of the value 
of intellectual pursuits in promoting health, it 
remains true that a great .many brain-workers are 
exposed to a serious danger. The effects of unre- 
lieved work with the mind are not always easy to 
trace. In the case of teachers, the system gets so 
gradually used to a low tone of physical life that one 
forgets the sensation of health, loses a standard for 
self- comparison, and does not become aware that 
ground is really lost until matters are already serious. 
To a person in vigorous health, with strong muscles, 
who feels his temper and digestion giving way under 
the influence of teaching, heavy gymnastics or field- 
sports of an active sort may be recommended. To 
the less vigorous or muscular person, and to most 
women who teach, a daily walk of from half an hour 
to two hours is necessary. It should be taken in 
company ; care should be left at home ; new scenes 
sought, and the object should be less to get fatigue 
by great exertions than to give the mind an oppor- 

34 



EXERCISE. 35 

tunity to take a view of life which school-work does 
not give. One chief benefit of walking is that it 
breaks up trains of thought. 

It is certainly worth while for women to cultivate 
muscularity, if they can do so with safety. A great 
many could walk five miles a day, and be the better 
for it ; others could not : and the way to find out is 
by trying. Beginning with two miles, one may grad- 
ually work up to five in the course of five weeks. 
Perhaps it may be necessary to restrict the amount ; 
but this must be learned by trial. 

Some persons, especially teachers, ought to enjoy 
almost absolute rest on Sundays. Few are really 
aware of the value of the Sabbath as a physical agent 
of health. The teacher should so use it as to get a 
sense of renewed life every Monday, and, unless in 
most vigorous health, should certainly not teach in 
the Sunday-school. 

It is difficult to state with accuracy the precise 
time when the frame of the body takes a permanent 
form ; it certainly varies in different cases ; but it is 
plain enough that there is a great difference between 
the years before twenty and those after. The re- 
quirements of a growing body, it cannot be too often 
repeated, are very different from those of an adult 
body. We urge gymnastics upon the adult in order 
to preserve the constitution ; upon the child, in order 
to form it. Circumstances often forbid the systematic 



$6 SCHOOL AND INDUSTRIAL HYGIENE. 

pursuit of gymnastics by adults; children have, or 
should have, no engagements or occupations to inter- 
fere with it. 

The benefits of gymnastics are of several sorts. 
Children are not to practise them chiefly for the sake 
of gaining great strength. They are to be used as a 
means of conferring grace of movement and the out- 
lines which indicate health and endurance ; of en- 
larging the chest, thereby giving free play to the act 
of breathing and the motion of the heart ; of strength- 
ening the latter organ by degrees ; of fortifying the 
muscular walls of the abdomen against rupture and 
the joints against accident; of confirming the habit 
of liberal consumption and ready assimilation of food 
(though play is better for this object). All these are 
best attained by the use of few and light apparatus ; 
at least, in the commencement. 

The word "calisthenics" implies the imparting 
of strength and beauty. There is a proverb that 
" beauty is but skin deep;" a very superficial view, 
indeed. Beauty of form is not skin deep ; it depends 
on the bony frame, on the development of muscles 
over the bones, and on the fatty layer over the mus- 
cles. A straight back may be said to be an element 
of beauty ; round shoulders and a twisted spine are 
an element of the opposite quality, beyond a doubt. 

It is well known to physicians that a large number 
of young girls in cities have a perceptible tendency 



EXEKCISE. 37 

to distortion of the spine at the growing. period of 
life. The case is certainly aggravated by confine- 
ment in school, by want of muscular exercise, and by 
improper positions in study. Boys do not exhibit 
this tendency to so marked an extent; but it is a 
thing to be constantly looked after in the case of 
girls. 

" In a school of 731 pupils at Neufchatel, 62 cases 
of deviation of the spinal column were observed 
among 350 boys, and 156 cases among 381 girls. 
These results are further stated not to differ materi- 
ally from those of examinations made in German 
schools. According to Adams, in 83 per cent, of 
782 pupils (649 cases), in which this deviation oc- 
curred, it was towards the right — probably in conse- 
quence of writing at unsuitable desks. According to 
Eulenberg, in 92 per cent. (276) of 300 cases, the 
curvature was also to the right. It is true that these 
curvatures are not always associated with public 
health, since they sometimes occur in a slight degree 
to the strong and well ; and it is true, also, that they 
may arise under influences not peculiar to school-life, 
such as the preponderating use of one or the other 
arm for any purpose. There can be but little doubt, 
however, that to the habit of writing at unsuitable 
desks belongs the largest share of blame. 

" In the statistics which I have given, the spinal 
curvatures were found to occur with much greater 
4 



38 SCHOOL AND INDUSTRIAL HYGIENE. 

frequency among girls than among boys, .partly due, 
no doubt, to the fact that they play fewer active 
games, and are, in general, more restrained in their 
movements. In a brief report of a recent meeting 
at Berlin, of some of the highest authorities of Ger- 
many, called together to consider the entire subject 
of the school education of girls, I find a notice of 
an address by Herr Raaz, principal of a school in 
Berlin, in which he speaks of the common occur- 
rence of these spinal curvatures in his school, and 
says that he has found the use of gymnastics to be 
powerful in preventing them." * 

Children should have several hours of play every 
day in the open air, when possible. Vigorous and 
spontaneous action of this sort is better than gymnas- 
tics for the general run of children; and if girls 
were allowed by social feelings to play as boys do, 
they would cease to be so subject to spinal deformi- 
ties. 

But a certain proportion of children are not suited 
by indiscriminate play. They have a tendency to 
distortion of the spine, which is easily brought out 
by many forms of sport. 

Any exclusive use of one side of the body is there- 
fore dangerous. Base-ball is a vigorous and useful 
sport ; but it is occasionally the cause of lateral dis- 

* James J. Putnam, M.D. " Gymnastics for Schools," in the 
American Journal of Social Science, No. VIII., 1876. 



EXERCJSE. 39 

tortion, owing to the excessive use of the right arm 
and hand. Bowling would seem likely to have the 
same tendency. Croquet is a very distorting game, 
unless both hands are used alternately, or one as much 
as the other, to strike the ball. 

The position of a woman on horseback is one 
which is apt to cause a "corkscrew" twist of the 
spine. And the common games of running and 
tossing, which do children so much good, are not so 
directly adapted to prevent or cure spinal deformity, 
or to make a girl full-chested and symmetrical, as is 
a course of gymnastic training under the charge of a 
competent person. 

Evidently, if we accomplish this greater object of 
correcting the weak points in the frame of a child, 
we gain at the same time those benefits — improved 
appetite, complexion, sleep, mental briskness — for 
which adult gymnasts so much prize their art. As 
for play, when can the girls in a city boarding- 
school, for example, play? Certainly not while on 
their daily walk, two by two, in the paved streets. 

" To establish a department for physical training 
demands but little change in the present school sys- 
tem, since almost any school-room may be trans- 
formed almost instantly into a gymnasium, no appa- 
ratus being required for the lower grades, and only a 
few light implements carried in the hands for the 
more advanced pupils, and each scholar needing only 



40 SCHOOL AND INDUSTRIAL HYGIENE. 

space enough upon the floor for a step in each direc- 
tion, and room to straighten the arms in front and at 
the sides. Of the pupils the requirement is slight, 
being merely that the dress shall be short enough to 
leave the feet unencumbered, loose enough to admit 
of a full inhalation without feeling the clothes at the 
waist or across the chest, and large enough to permit 
the free play of every muscle in the body. For this 
no special costume would be required, except in the 
highest grades. Music is a great addition to the ex- 
ercise, but not a necessity. But the great difficulty, 
and, in fact, the only serious one, is the dearth of reg- 
ularly trained teachers of gymnastics, who are not 
only fully prepared for the work, but who are enthu- 
siastic in the cause, and able to impart their informa- 
tion to others. This arises from the low standard of 
physical culture admitted by public opinion. Let it 
once be required, that those who teach this branch 
shall of necessity be regularly trained, and there will 
be a supply of good teachers in a marvellously short 
time."* 

"In Sweden, the celebrated system of Ling is an 
obligatory study in all public schools, three to six 
hours a week being devoted to it, subject to the ad- 
vice of a physician, who is appointed to examine each 
scholar at the beginning of the school term. For the 

* Quoted by Dr. Putnam from a letter received from a teacher 
of gymnastics in a "girls, normal-school." 



EXERCISE. 41 

education of teachers there is a great central institute 
at Stockholm ; and the graduates from the normal- 
schools must moreover have passed a special exami- 
nation in this branch. A large part of the instruc- 
tion is in the so-called ' free exercises,' including 
proper methods of sitting, standing, lying, walking, 
running, jumping, as well as exercises in concert, 
games, etc. The aim of these free exercises is to 
call into action in turn the greater part of the volun- 
tary muscles of the body ; and with an intelligent, 
earnest teacher to direct them, there is no end to the 
modifications and combinations that can be made, 
calling for precision and strict attention and skill on 
the part of the pupils." [Ibid.'] 

The city of Frankfort-on-the-Main is an illustra- 
tion of what may be done by an enlightened commu- 
nity, led by far-seeing hygienic genius. Gymnastic 
exercises were first introduced there nearly seventy 
years ago ; but the progress has been very slow in- 
deed, and it was only a few years ago that the regu- 
lar practice of such exercises, under trained teachers, 
was made obligatory upon the public-school children 
in that city. Most of the twenty-five schools already 
possess a "turn-halle," and others are building. The 
new halls pre to be from 20 to 25 meters long (66 — 
S3 feet), 9 or 10 meters wide, and 5 — 5.6 meters high 
(about 17 — 18 feet); they are all well furnished with 
4* 



42 SCHOOL AND INDUSTRIAL HYGIENE. 

apparatus ; that used by girls differs somewhat from 
that used by boys. 

There were 12,101 children in the public schools 
in 1878, of whom 10,844 attended schools where 
gymnasiums existed and exercise was obligatory. A 
medical certificate of disqualification is required of 
those who are excused ; the number wholly excused 
amounted to two and a half per cent. The scholars 
exercise two hours every week. They are always un- 
der the charge of teachers specially qualified for the 
work by instruction received in gymnastic normal- 
schools, and in classes taught by the inspector of 
gymnastics. These teachers are not ignorant men, 
nor "pure specialists" of gymnastics; they are all 
regularly qualified teachers of the literary branches, 
and the hours during which they are engaged in teach- 
ing gymnastics are counted in with the twenty-six 
required weekly hours, just as so many hours of Latin 
or music would be counted. One hundred and four- 
teen teachers are thus employed, performing an amount 
of duty equivalent to foe. full time of seventeen teachers ; 
which may be estimated as costing the city 46,270 
marks, or about one dollar for each child. The value 
of this exercise to the teachers is as great as to the 
pupils. 

It is thought desirable that the number of weekly 
hours should be increased. Another recommenda- 
tion is made by the authority from whom I quote 



EXERCISE. 43 

this account,* to the effect that the city should pro- 
vide public places for children to play in, both for 
sanitary and moral reasons — a recommendation which 
is as important in America as in Germany. 

It is interesting to remark that the youngest chil- 
dren use chiefly free-hand exercises ; that the boys 
take the fixed apparatus by degrees, and at last use 
them chiefly; while the girls, who in the middle 
classes use fixed apparatus like the boys, in the upper 
classes return, for the most part, to the use of lighter 
instruments, suitable for young children. 

Public sentiment is not at present favorable to such 
thorough-going work in America. To the crowds of 
men and women in our large cities who were born in 
the country, and remember its free and natural sports, 
its days spent in the open air with the beasts, fowls, 
and fishes, a course in gymnastics will seem but a 
tame thing. Those city men who have been forced 
to use a gymnasium for their health, have not gener- 
ally a very cheerful impression of the place. In fact, 
the actual substitute, in our cities, for that immensely 
popular German institution, the Turn-Verein, is the 
volunteer militia company, which gratifies the love 
of exercise, the social instinct, and the love of rule, 
order, and co-operation in a very similar way. 

A gymnastic class in a school should consist of the 

* G. Danneberg : Das Stadtische Schuitumen zu Frankfurt 
a. M. 



44 SCHOOL AND INDUSTRIAL HYGIENE. 

scholars in one room, or any suitable fixed number; 
their teacher should have precisely equal authority 
with their class-teacher (in Amherst College, the 
teacher is a Professor and member of the Faculty) ; 
and the exercises should be controlled as those of a 
soldier are — not with the same stiffness, but with 
constant care lest the boys injure themselves by am- 
bitious efforts. 

Even in Frankfort, the present complete system 
has only been introduced in the most gradual man- 
ner. If it is ever made a part of the American sys- 
tem, — and I cannot see why it should not ultimately 
be, — the same way must be followed. I would sug- 
gest, as a stepping-stone, the introduction of a very 
thorough gymnastic training in our normal-schools. 
In three years, a young woman cannot only much 
improve her own constitution, but can become im- 
pressed, from experience, with the value of gymnas- 
tics. The great difficulty to be overcome is the fact 
that few teachers really know what physical exercise 
can do for a person ; what elasticity and smoothness 
of temper ; what power of continued attention and 
work it is capable of imparting. 

Girls really need gymnastics more than boys, in 
cities, owing to the very great restraint placed on 
their freedom, and the improper modes of dressing 
which still prevail. One of the readiest ways to per- 
suade young women to dress rationally is to make 



EXERC/SE. 45 

them feel by contrast the comfort of living in bodily 
freedom, as must be done, for the time, at least, by 
those who practise gymnastics. 

Would it be too great a luxury for a democratic 
community to indulge in, if all children were in- 
spected by the quick and practiced eye of a medical 
expert, once a year, especially during the ages of 
rapid growth? and if the results of such examinations 
were made known to the teachers of gymnastics for 
their guidance? In every hundred children, there 
are always some who are tending to special deformity. 
It would be very easy, in most cases, to prevent this 
by suitable exercises, performed with very cheap ap- 
paratus, for a short time, every other day. Other 
children are weakly, and should have special exemp- 
tions. 

The adoption of special teachers in gymnastics is 
strongly to be urged. It is too much to expect of 
the literary instructors that they shall always be 
strong enough to perform the severe duties of in- 
structing in gymnastics three times a week. Such 
duties are much more toilsome for the teacher than 
for the pupil. There are plenty of most valuable 
instructors who could not bear the additional strain. 
But as regards calisthenics of a very light description, 
performed daily once or twice, for relaxation more 
than for development, the ordinary teacher is per- 



46 SCHOOL AND INDUSTRIAL HYGIENE. 

fectly competent to perform and teach them. I will 
give a specimen of the latter to illustrate : 

" Body erect, heels together, feet at angle of 6o°, 
chin not protruding, eyes front, hands closed, knuc- 
kles touching shoulders as nearly as possible, elbows 
touching sides with exactness. 

" Right hand down, up, down, up; left hand down, 
up, down, up; right down; right up and left down; 
right down and left up; right up; both down, up, 
down, up (16 movements). 

" The same alternation may be applied to forward 
movements resembling a boxer's blows, and to lateral 
and upward movements. This series is one of the most 
elementary, and when learned so that the whole class 
does it with prompt uniformity and in good time, — 
the music, if possible, of a piano or drum, — a slight- 
ly harder series may be undertaken. This course will 
bring into use, by degrees, all the chief muscles in 
bending and twisting the trunk, limbs, and neck." 

Military drill is an excellent thing in general ; it 
should, however, be restricted to the stronger boys. 
Small and weak fellows are easily injured by carrying 
a musket for a long distance. My friend, Dr. Buck- 
minster Brown, has mentioned to me one or two 
cases in which he believed congestion or inflamma- 
tion of the membranes of the spinal cord at the 
level of the shoulders to have been thus caused. 

In a long session, there should be a pause at the 



EXERCISE. 47 

close of every hour, in which the scholars should be 
allowed to go out of doors. 

A short session of three hours may require only 
one pause, which should, however, be of twenty or 
thirty minutes, in the case of children. 

Clothing should at all times be easy and allow full 
inspiration by chest or abdomen, without any sense 
of pressure ; the feeling should be nearly the same as 
when no clothes are worn. The so-called "dress 
reform" for women effects this by making most of 
the weight depend from the shoulders. 

One of the chief faults of feminine attire — the 
pinching of the waist where the skirts are fastened — 
is imitated by boys with a leather strap. It is dan- 
gerous to exercise with a tight strap or string around 
the middle. 

The feet are often neglected. Children (old enough 
to "study philosophy") will come to school in thin, 
wet shoes from simple negligence, or because they 
have "lost" their rubbers. They should be sent 
home by the teacher for dry shoes and stockings. 
On very wet days it would not be amiss for the pupils 
to bring at least a dry pair of stockings to school 
with them. This is especially important for oldei 
girls. 



CHAPTER VII. 

CARE OF THE EYES. 

THERE is no hygienic point where the teacher 
can render more distinct service than in rela- 
tion to the eyes of his scholars. The functions of 
this organ are so dependent for their perfection 
upon a thoroughly sound condition of health, that 
a complete account of their relations would bring us 
in contact with most points of hygiene. But, of all 
public servants, the teacher ought to be best informed 
of the dangers, and best able to assist the child in 
avoiding them. 

In the valuable little treatise on the " Care of the 
Eyes," by Mr. Brudenell Carter, we find these words, 
which may be laid to heart : 

"It is very worthy of note that, in the experience 
of ophthalmic surgeons, it is exceptional to meet with 
a child suffering from defective vision who has not, 
before the defect was discovered, been repeatedly 
and systematically punished by teachers or school- 
masters for supposed obstinacy or stupidity. The 
very reverse of this practice is what ought to obtain, 

48 



CARE OF THE EYES. 



49 



and apparent obstinacy or stupidity should lead, from 
the first, to the question, 'Can you see perfectly?' " 

It may be added that deafness, due to causes easily 
removed if taken in time, is often misunderstood in 
the same deplorable way. Deafness, however, cannot 
be considered a "school disease " in the same sense in 
which many diseases of the eye are such. Both the 
eye and the ear, however, are peculiarly the instru- 
ments of school-education, and a teacher who is ig- 
norant of their essential construction and laws knows 
not the tools of his trade. 

There is one affection which is so common, and so 
directly dependent (in many cases) on -,chool-life, 
that it may well occupy our first attention. I refer 
to short-sight, near-si B ht, or myopia. 

A child with normal eyes ought to be able to read 
this page, in a good light, at the distance of forty 
inches, and at all intervening distances down to four 
inches: this is a very moderate test for young eyes. 
Any child who cannot read it as far as fifteen inches 
off should have his eyes examined by a competent 
oculist. No disease is more certain to increase if 
neglected, and none is better understood by scientific 
experts, and r_.ore susceptible of exact statement and 
ready correction. 

The near-sighted eye is one which has too great a 
diameter from front to rear, so that the retina — which 
lies at the rear — is beyond the point at which pencils 
S D 



50 SCHOOL AND INDUSTRIAL HYGIENE. 

of rays from far objects are focalized. This condi- 
tion is illustrated by the following diagram from Dr. 
Harlan's Health Primer, in this series, on "Eye- 
sight, and How to Care for It," in which the whole 




lines represent the outline of the normal eye with 
the lens, and rays of light from a distant object com- 
ing to a focus on the retina; while the dotted lines 
represent a near-sighted eye, with rays from a very 
near object coming to a focus. In near-sightedness, 
rays from distant objects may be represented by the 
whole white lines, which are focalized before reach- 
ing the retina, giving a diffused image, in which each 
point of the object is seen as a larger blurred point 
and each line as a wider blurred line. 

This defect is irremediable when it exists as an 
anatomical fault ; but very much may be done to 
prevent its increase when discovered, especially in 
children. It must be remembered that some chil- 
dren are looked upon as near-sighted because they 
have the habit of holding their work too close to 



CARE OF THE EYES. 5 1 

their eyes. This habit may arise from the very oppo- 
site cause, namely, far-sight ; it may originate in 
sheer indolence, a faulty desk or seat, or poor light, 
and may be continued merely as a habit. And the 
degree of near-sight is easily over-estimated by those 
not able to apply the scientific tests of the professed 
oculi&t ; for in many cases there exists a temporary 
exaggeration of near-sight, due to the strain entailed 
by the effort to read or see fine objects, which easily 
passes away with change of occupation. 

In order to prevent, we must first understand some- 
thing of the causes of this complaint. 

There is a strong tendency for the malformation, 
once developed, to be transmitted to children. In 
all probability, near-sight begins, in many children, 
at a very early age ; but in most cases a great deal 
can still be done to prevent its increase. 

It is believed that an eye which is predisposed to 
near-sight has naturally a more yielding and delicate 
envelope, which, under the influence of close appli- 
cation to near vision, yields to the compression which 
that act necessarily causes (and causes, also, in a 
sound eye) ; and as the yielding occurs chiefly at the 
rear of the eyeball, that portion is very gradually 
pushed back, and the whole globe becomes elongated. 

This tendency to yield may exist as the result of 
three causes : first, as an inheritance from near-sighted 
parents ; second, as a characteristic of weakly, flabby 



52 SCHOOL AND INDUSTRIAL HYGIENE. 

children, with tissues which do not resist pressure 
well ; and, third, as a general characteristic of child- 
hood, when all the tissues are soft. 

Of prevention, as applied to the first of these causes, 
I will not speak ; but the second is at once suggestive 
of the great importance of preserving strong and 
lusty health for the sake of the eyes ; and as to the 
third, it affords a hint that childhood is not, perhaps, 
a suitable time for close application with the eyes. 

Robust and active children are less likely, on the 
whole, to be affected, both because their tastes lead 
them into the open air rather than to books, and be- 
cause they generally possess a tougher fibre. Any- 
thing which depresses vitality is capable of weakening 
the power of vision. Bad air in school-rooms is cer- 
tainly capable of causing bad eyes ; it provokes the 
general condition of listlessness and languid function 
which predisposes to near-sight and other diseases of 
the eye. Fresh air in the school-room is absolutely 
necessary for this reason. Delicate health, dyspepsia, 
catarrhal, and other weaknesses may be considered as 
aiding the tendency to near-sight. Convalescence 
from acute fevers, as measles, is often associated with 
a weakness of the eyes which should forbid their use 
for a time. Diphtheria not seldom causes a paralysis 
of sight, which should be very carefully looked after 
both by teacher and doctor, and all use be prohibited 
until complete recovery ensues. 



CARE OF THE EYES. 53 

It is a false and mischievous view that considers 
the near-sighted eye a strong eye. Such an eye is 
"strong" only in respect to minute objects, while, 
for almost all the pleasures and duties of life, it is a 
half-blind eye. There is, too, a tendency, happily 
seldom realized, to destroy sight by separation of the 
retina from the outer coats of the eye — a painless 
process, but frightful to contemplate as the possible, 
and in fact the logical, termination (so to speak) of 
near-sightedness. 

The mechanical pressure exercised in the act of 
looking at near objects by the muscles used in fixing 
the globe has been mentioned. The distention which 
this pressure tends to produce is quickly recovered 
from if the eye is rested often ; its effects are exag- 
gerated by the excessive fineness of the objects looked 
at (as in embroidering, and small maps and type), by 
poor light, by fatigue, by sleepiness, by an over- 
heated room, or cold feet ; by tight clothing around 
the neck, by the effect of a recent hearty meal, or by 
protracted use of the eyes ; and, in general, by any- 
thing which causes congestion of the eyes. The eyes 
are decidedly better able to bear fatigue in the fore- 
noon than in the afternoon. The position of the 
body is important ; stooping forwards should be pro- 
hibited, and the eyes not allowed to approach nearer 
than fifteen inches in general to the book or slate. 
The proper shape and proportion of a desk which 
5* 



54 SCHOOL AND INDUSTRIAL HYGIENE. 

will facilitate the fulfilment of these requisitions will 
be described hereafter, as well as the proper arrange- 
ments for lighting a room. 

The reader is referred to Dr. Harlan's work in this 
series for a fuller account of " How to Care for the 
Eyesight ' ' than can be given here. A few remarks, 
however, are here quoted : 

"It is well in reading to interrupt the strain of 
continuous gaze upon the page, and rest the eyes, by 
looking into the distance occasionally, even if only 
for a few seconds. In studying, or in reading any- 
thing that requires thought, this is likely to be done 
unconsciously ; the natural condition in close thought 
is rest of everything except the brain. 

" As distant vision represents rest for the eyes, and 
near vision represents exertion, care should be taken, 
in reading, not unnecessarily to increase this exertion 
by holding the book too close. The book should not 
be held nearer to the eyes than is necessary to make 
the print appear perfectly sharp and distinct, and no 
print should be read continuously that cannot be seen 
clearly at about eighteen inches. 

" Without any optical or other discoverable reason, 
or, perhaps, merely in consequence of a careless and 
lounging way of sitting, young people often acquire 
the vicious habit of reading with the book held close 
to the eyes — a habit which, if examination of the 
eyes proves it to be nothing more, should be strictly 



CARE OF THE EYES. 55 

discouraged. It is very important, however, to de- 
termine positively that there is no physical cause for 
the habit, and to remember that true short-sight de- 
pends upon the form of the eyeball, which no amount 
of discipline can alter. Great injustice is often done 
to children by accusing them of obstinacy or inat- 
tention, when they are the subjects of physical defects 
of sight or hearing. Those with a high degree of 
long-sight are particularly liable to be misunderstood ; 
for, though they can see distant objects better than 
near ones, they sometimes hold the book close to the 
eyes to make the print appear larger, and thus par- 
tially compensate for their dimness of sight. Chil- 
dren with astigmatism often appear stupid or inatten- 
tive, because there is in this defect what the subjects 
of it sometimes aptly call ' slow sight ; ' that is, they 
do not recognize a word quickly on first sight, but 
' it seems to come to them afterwards.' Astigmatism 
is that condition in which all lines running in a given 
direction look blurred — as all the upright or all the 
horizontal, etc. 

" In reading while lying down, it is hardly possible 
to hold the book in a favorable position, and the ex- 
ternal muscles of the eye are strained. In addition 
to this, when the head is on a level with the body, 
instead of erect, there is a tendency to an excess of 
blood in the eyes. 

" It is not well to persist in reading when overcome 



56 SCHOOL AND INDUSTRIAL HYGIENE. 

with sleep, as there is a constant tendency for the 
muscles of accommodation to relax, and of the eyes 
to diverge, and they have to be forced back to their 
work by an effort of the will. The effect of this is 
soon shown in a congestion of the blood-vessels of 
the conjunctiva [white of the eye]." 

This is the place to speak of the excessively bad 
and trying character of the letters on many maps 
used in schools. Some most excellent works, as re- 
gards thoroughness and execution, are absolutely in- 
tolerable on account of the fineness of the engraving. 
Other maps, printed from old and worn plates, are 
sold, which it would require the microscope of an 
expert to decipher. Maps for children ought to con- 
tain few data; geography should be largely taught by 
wall-maps and outline maps; and long search for 
places, too often hidden like " the needle in the hay- 
stack," should be discouraged. 

Greek letters are not harder to read than a clear 
manuscript, if they are well printed. There is an 
old Greek type which is very trying, however. Lex- 
icons are an indispensable part of a classical educa- 
tion, and the utmost care should be given to clearness 
of type. 

The most agreeable tint for paper is either a cream 
color, like that of this page, or a pale blue (which is 
commonly taken for clear white), produced by adding 
a pigment. The practice of calendering the sheets, 



CARE OF THE EYES. 57 

to give a gloss, is altogether improper, for it causes 
them to throw a dazzling reflection in many lights. 

It should be remembered that drawing, when the 
eyes have frequently to look from the page to a dis- 
tant object, may be quite fatiguing. Drawing maps 
on a small scale must be forbidden ; no names, for 
instance, should be inserted in a smaller handwriting 
than that which is usual. A large handwriting for 
ordinary purposes should be taught. Fine embroid- 
ery and lace-work are notoriously destructive to the 
eyes. As an illustration of the effect of too close 
work with the eyes, I will mention a recent minute 
edition of Dante's Divine Comedy, which occupies 
a volume measuring 2 by 1 T 4 D inches. The type is so 
minute that it had to be destroyed after use, owing to 
the impossibility of distributing it ; and several work- 
men had to stop working on it on account of the 
injury it caused. 

Pale ink and greasy slates are trying to the eyes. 
Some other points will be mentioned hereafter. 

The connection of near-sight with school-life and 
work has received a great deal of attention within 
the past twenty years. Statistics were first published 
by Cohn, of Breslau, who examined the eyes of 
10,060 school-children, and found that of this num- 
ber 1004 were near-sighted. Since then many ex- 
aminations of smaller numbers of children have been 
made in Germany, Russia, Switzerland, and America, 



58 SCHOOL AND INDUSTRIAL HYGIENE. 

with strikingly similar results. It seems to be a uni- 
form fact, that the youngest classes have the fewest 
near-sighted children and the oldest the most. In 
Konigsberg, the difference was found to be as nearly 
six to one. In New York, the difference was nearly 
as eight to one.* It may be a matter for congratu- 

* Statistics by Drs. E. G. Loving and R. H. Derby, the ages 
ranging from 6 to 21 years. Percentages in the lowest classes, 
3.50 ; in the highest, 26.78, near-sighted per hundred. 

Other American observations give the following results : 

Cincinnati, 630 students : District schools, 10; Intermediate, 
14; Normal and High, 16, near-sighted persons in 100. 

Brooklyn Polytechnic, 300 students : Academic Department, 
10 per cent. ; Collegiate Department, 28 per cent. 

New York College, 549 students: Introductory class, 29; 
Freshman, 40 ; Sophomore, 35 ; Junior, 53 ; Senior, 37 per cent. 

Buffalo public schools, 1003 pupils: the percentage of near- 
sightedness increased from 5 at seven years of age to 26 at 
eighteen years. It was further ascertained that one of every 
four graduates of the Buffalo High-School was near-sighted. 

Dayton (Ohio) public schools, 765 pupils: near-sighted, 18.96 
per cent. 

In Amherst College, as has been shown by the very careful 
examination recently made by Dr. Hasket Derby, the percent- 
age of normal eyes, on entering, is 50.8 ; on graduating, 36. 
The percentage of far-sight on entering is 5 ; on graduating, 
13.2; that of near-sight on entering, 44.2 ; on graduating, 50.8. 
Amherst students have the reputation of working well at their 
books, and they are certainly not a puny or unwholesome set. 
They are rather largely country boys. This refers to the class 
graduating in 1879. 

The statement for the class of 1880 (which I owe to the kind- 



CARE OF THE EYES. 59 

lation that we have in America fewer actual cases of 
near-sight, — perhaps one-half as many as in Germany; 
but it would seem that the tendency of near-sight to 
increase rapidly as school-life advances is quite as 
marked here as there. 

It is really a serious question whether the attain- 
ment of high culture is necessarily attended by my- 
opia in a large percentage of persons. The German 
nation is a spectacled nation : it has not lost its mil- 
itary qualities nor its intellectual preponderance in 
certain directions ; but who likes to think of a uni- 
versal use of glasses for ordinary vision by children 
and adults alike? And yet, if it were possible to 
send the whole nation to school up to the age of 
eighteen (in their way), this result would seem likely 
to follow. Perhaps among the drilled and orderly 
masses of Germany, where the boys (little old men) 
never throw stones or steal apples, the disadvantage 

ness of Dr. Derby, as it is not published) is to the effect that 
near-sight developed from previous normal sight in 7 per cent, 
of the whole class increased in amount in t,]/ 2 per cent., and re- 
mained unchanged in 22.8 per cent. This is favorable, as com- 
pared with other statistics. Perhaps the mere fact of attention 
being paid to the subject has increased the care of the students; 
doubtless the gymnastic exercises have had a good effect. 

These statistics, except the first and last, are quoted from the re- 
port of Dr. Conklin, of Dayton, upon the " Effect of School-Life 
upon the Eyesight," printed by the School Board, 1880. They 
are not very extensive, but ihey should dispel the idea that near- 
sightedness will take care of itself in America. 



60 SCHOOL AND INDUSTRIAL HYGIENE. 

of partial blindness is not so great as it would be 
here; yet who wants a near-sighted policeman, or 
sailor, or stage-driver, or a spectacled actor or singer? 
The effect of near-sight upon the character has not 
been studied. We would add, for the thoughtful 
consideration of parents, these words from Mr. Car- 
ter's book : 

"It will be manifest, on reflection, that the mat- 
ters which are lost by the short-sighted, as by the 
partially deaf, make up a very large proportion of 
the pleasures of existence. I am accustomed, on 
this ground, strongly to urge upon parents the neces- 
sity of correcting myopia in their children ; and I 
am sure that a visual horizon limited to ten or even 
twenty inches, with no distinct perception of objects 
at a greater distance, has a marked tendency to pro- 
duce habits of introspection and reverie, and of in- 
attention to outward things, which may lay the foun- 
dation of grave defects of character." 

Homer was, assuredly, the possessor of a good 
pair of eyes — at least, in his youth ! 

If near-sight is at all connected with compulsory 
and protracted education, — that is, with the methods 
by which modern civilization is supported, — it be- 
comes a national question of a grave character, 
whether the connection is a necessary one, or whether 
means for preventing its growth are not feasible. 
These means do exist, and it is our duty to urge 
their adoption. 



CARE OF THE EYES. 6 1 

Children are incapable, for physical reasons, of 
enduring long protracted effort. This is true not 
only of the mind, but of the eye, and for very 
tangible reasons. Their tissues are soft, — bones, 
tendons, muscles, and skin alike, — and yield readily 
to pressure. Now, no fact is better known than that 
near-sightedness is increased by- the yielding of the 
fibrous coats of the eye under the pressure of the act 
of reading ; and it is equally well known that child- 
hood is, par excellence, the period when near-sight- 
edness commences. Nature forbids the young child's 
brain to be used for a single task more than fifteen 
minutes or so ; and to this fact, now understood by 
most teachers, should be added that the child's eye 
will not bear anything like the continuous strain that 
an adult's will bear. 

Children differ greatly in this respect, no doubt ; 
but the State should not exact tasks which are likely 
to injure even a small proportion of the whole. 

A school for young children should present a very 
different aspect from that offered by an academy. 
The eyes should frequently wander. If academic 
tasks are given, the evidence of momentary fatigue 
and inattention should not be interdicted. If the 
school is held in the afternoon, in summer, what can 
prevent an occasional nap ? (It may be remarked, 
by the way, that no one should read while sleepy, or 
just after waking. ) A rational regimen for children 
6 



62 SCHOOL AND INDUSTRIAL HYGIENE. 

should include vigorous play, or mechanical or agri- 
cultural instruction, for a considerable part of the 
day, with very limited hours of study. The latter 
must be interrupted, for the youngest children every 
quarter of an hour, by a change of position, stand- 
ing, walking about, and by change of study ; for 
older children the intervals may be less frequent; but 
until maturity is nearly reached (say until the age of 
sixteen), it is best to have a complete break at the end 
of every hour for a few minutes at least, with enforced 
cessation of eye-work. 

If it be proved, as it has been over and over again 
in England, Germany, and America, that children 
under twelve learn as much in three hours a day as in 
five, there would seem to be no excuse whatever for 
the cruel custom of confining them for the present 
period, with the consequent (we may fairly say the 
consequent) inevitable injury to the eyesight of many. 
Parents are not to be blamed for desiring that their 
children shall gain knowledge rapidly; but it is to be 
feared that it will be long before they practically as- 
sent to the truth of the proposition, that young chil- 
dren become tired after three hours of study, and that 

Three hours of good work are better than five hours 
of poor work. 

Children not infrequently have far-sighted eyes, 
which are not fitted for continuous work upon near 
objects, and which, of course, cannot be made fit by 



CARE OF THE EYES. 63 

any effort of the will. This defect is very liable to 
be neglected. It often causes headaches, which may 
easily be attributed to a difficulty of the brain. 
Convergent squinting is very liable to be the result 
of neglected far-sight in children. The remedy for 
far-sight is very simple indeed, consisting in the use 
of convex glasses. It is utterly useless to spend time 
on other methods ; either the child must give up 
study, and all work requiring the inspection of near 
objects, or he must wear glasses constantly for such 
work. 

When near-sight is considerable, glasses should be 
worn "as a part of the eye." If it is very consid- 
erable, two pairs must be used — one for far objects, 
the other, much weaker, for use in writing and read- 
ing. It is certain that any degree of near-sight 
which compels the child to stoop to work at ordinary 
well-made desks is productive of congestion and 
strain in continued study, which is highly prejudicial 
to sight ; this injury may be avoided easily, comfort- 
ably, and safely by the use of weak glasses. 

It is proper to warn teachers of the contagious na- 
ture of certain cases of conjunctivitis (inflammation 
of the outer covering of the eyeball, ophthalmia), 
and of inflammation of the edge of the lids. A 
physician is the proper judge of such cases. 

All spectacles or eye-glasses should be selected by 
an oculist, /'. e., a physician trained to the special 
care of the eyes, and never by a mere optician. 



CHAPTER VIII. 

SCHOOL-DESKS AND SEATS. 

AMONG the prominent causes of deformity of 
the spine and of near-sight among scholars, is 
the disproportion or otherwise bad construction of 
these necessary pieces of furniture. 

"To bad positions in writing, drawing, at the 
piano, etc., also while standing during recitations 
(upon one foot) ; to carrying weights, heavy books, 
for example, more on one arm than the other ; to 
too much exercise of one arm, while the other is 
comparatively idle, can undoubtedly be traced the 
majority of these curvatures (z. e., rotato-lateral cur- 
vature of the spine). But it is not malposition alone 
that causes the trouble. It is likewise due to long 
continuance in one position, which at first may be a 
good one, but which, if continued for a considerable 
length of time, becomes changed, from simple fatigue 
of a certain set of muscles, into a bad one. These 
relax ; sometimes one muscle or set of muscles gives 
way ; sometimes another set. The burden of support 
is consequently thrown, to a great extent, upon the 

64 



SCHOOL-DESKS AND SEATS. 65 

ligaments which bind the vertebrse together. These, 
in a young person, are soft ; their elasticity is soon 
overcome, and they are stretched. The chain of 
bones of which the spine is composed yields. The 
muscles and ligaments no longer do their work, and 
the superincumbent weight of the head and shoulders 
bends the chain, or perhaps the preponderance of 
other muscles, not so easily fatigued, disturbs the 
equilibrium, and a curve is the result. This curve 
may commence in the dorsal region, between the 
shoulders, or it may begin in the loins." * 

Such a curve is easily straightened at first, but 
becomes a "fixed fact" after a while, owing to a 
permanent change in shape assumed by the vertebrse 
under the influence of continued pressure. 

The faults in school-desks and seats which tend to 
produce deformity and defects of sight are the fol- 
lowing : 

1. Desk too low, causing a forward stoop, with 
tendency to congestion of the head and formation or 
increase of near-sight. 

2. Desk too high, causing undue elevation of one 
shoulder, usually the right, with tendency to spinal 
curvature. 

* Buckminster Brown, M. D. : " Influence of the Prevailing 
Methods of Education on the Production of Deformity in Young 
Persons," etc. Lecture delivered before the American Social 
Science Association, Department of Health, 1879. 
6* E 



66 SCHOOL AND INDUSTRIAL HYGIENE. 

3. Desk too far from the seat, with stoop of the 
body, injuring the eyes. Both here and in No. 1 
there is danger of injuring the health by compression 
of the abdomen and chest ; dyspepsia, small chests, 
round shoulders. 

4. Flat desk-lid, interfering with freedom in writ- 
ing, disadvantageous as respects receiving the light, 
and compelling the child to hold up his book in order 
to see. 

As to seats, we have : 

5. Seat too high, so that the feet are not supported, 
and the legs grow weary. 

6. Insufficient support for the back, causing fatigue 
and improper attitudes, and consequent tendency for 
the spine to yield and take a side-curve. 

7. Seat not hollowed suitably, causing pain and 
restlessness. 

8. Well-proportioned desk and seat, not adapted 
to the age of the child using them. 

In general, discomfort is an indirect cause of 
deformity, as it invariably leads a child to take 
improper positions. 

Let us now consider the construction of good seats 
in detail, making allowance for differences of opinion 
among authorities. A medical friend of the writer's, 
who has long and carefully studied the question, and 
has children of his own in school, concludes that 
desks ought to be abolished, and arm-chairs substi- 



SCHOOL-DESKS AND SEATS. 6? 

tuted. This opinion is only an individual one, how- 
ever, and we shall assume the necessity of desks. 

The desks used for American public schools are 
usually fairly good, though there are glaring excep- 
tions. The newer models usually give a separate seat 
for each child, which is desirable in the interests of 
discipline and cleanliness ; and as regards shape and 
proportion many are praiseworthy. The chairs are 
commonly made comfortable by a slight backward 
tilt of the back-piece, and a corresponding upward 
tilt of the front of the seat-piece. The scholar can 
thus find perfect support in reading when desired. 

Liebreich considers that " the back ought to be 
straight, and consist of a piece of wood only three 
inches broad ; " "not high, and not slanting back- 
wards;" "the top to be one inch lower than the 
edge of the table for boys, and one inch higher than 
the edge of the table for girls." 

The national characteristics are shown in this dif- 
ference. The American seat is thoroughly easy to 
lean back in ; the German seat is suited to keep the 
child in an erect, semi-military attitude, with right 
angles at the knees and hips ; and, in point of fact, 
it does keep him so, by the help of discipline. 

What are the requirements of a good seat and 
desk? 

First, it may be said, it is necessary that they 
should not tend to produce deformity of the spine. 



68 SCHOOL AND INDUSTRIAL HYGIENE. 

It should be remembered, however, that a child is 
not, or ought not to be, kept sitting very long at a 
time — fifty minutes at the most. He does not re- 
quire a chair to lean against continuously, but for 
occasional support by way of change. To quote an 
expression of Professor Henry J. Bigelow's (Harvard), 
"Rest against a well-made chair-back at will,- — change 
of posture and variety of movement at will, — seem 
to me the best prophylactic against curvature." 
Whether a perpendicular back or a tilted back is 
used is not essential ; either kind, if rightly made, 
is comfortable. 

Second, an upright position in writing is indis- 
pensable ; yet it is extremely rarely seen. The seat 
must at least not interfere with such a position. The 
desk-lid must not project so far as to touch the 
stomach ; but that fault is hardly likely to occur. 

The German plan of an upright back probably 
assists in forming the habit of sitting erect, and is on 
this account desirable. It seems to me perfectly 
suitable for all children who have not a commencing 
curvature of the spine. If the latter condition ex- 
ists, or if there is a tendency to it, a slightly inclined 
seat is better, as giving more perfect rest or relaxa- 
tion. Not that such relaxation should be maintained 
throughout the time of study, but it should be per- 
mitted at the scholar's will. 

The child who is sitting erect, with the knees at 



SCHOOL-DESKS AND SEATS. 69 

right angles, the back against an upright support, and 
the wrists on the table, is well balanced. The posi- 
tion 1 is comfortable, not because of the amount of 
support given, but because the support is well placed. 
It is suited to a well and vigorous person, although it 
does not give so much rest to the over-fatigued body 
as a tilted seat does. 

If the light is bad, children cannot be prevented 
from stooping. 

Near-sighted children should be placed in the best 
light, and, if the defect is marked, should have weak 
glasses to read or write with. 

If the desk and seat are suitably proportioned, the 
former will be only from six to ten and a quarter inches 
higher than the latter; and the book will be from 
fifteen to eighteen inches distant from the eyes of a 
scholar sitting upright. Near-sight is not uncommon 
to an extent which makes it uncomfortable or impos- 
sible to read at those distances. It is thought by 
modern ophthalmologists, in such cases, much safer 
to give a pair of weak glasses than to permit a child 
to get the habit of stooping forward, which, of itself, 
tends to increase near-sight. 

The most luxurious position in writing is one in 
which the back is well supported, with a lean back- 
ward, and the desk-lid comes pretty well forward, in 
fact, within three or four inches of the stomach. 
Desks have been constructed with this object ; but 



JO SCHOOL AND INDUSTRIAL HYGIENE. 

scholars will not write leaning back. The posture 
may be enjoyed for a time, but it interferes with 
other work ; it is interrupted by reaching to dip the 
pen, to get books, etc., and the support at the back 
is soon abandoned for the more congenial one af- 
forded by the elbows resting upon the desk. 

It is an excellent thing if the lid of the desk can 
be made in two pieces, hinged together, so that the 
piece next the scholar can be raised to an angle of 
40 or 45 , and form a book-rest. 

It seems to me difficult to maintain an absolute 
statement regarding the proper shape of seats. The 
reader sees that there are good arguments both for 
the tilted and the straight seat. There is good au- 
thority for saying that the back should be fully 
supported in a slightly tilted posture in writing; but, 
in view of the necessity in after life of writing in the 
erect position, it would seem that the child should at 
least be taught to do it so. 

The child may take any position he likes, provided 
he does not keep it long. The more he varies his pos- 
ture from moment to moment the safer he is. But he 
does not usually vary it much in writing ; he gets one 
or two favorite bad positions, and only varies them in 
degree. It is excessively hard to change such habits 
when once formed. The primary school is the place 
to form the child in this respect. It is, however, 
unnatural for a young child to sit long in one posture. 



SCHOOL-DESKS AND SEATS. "}\ 

A primary class must be allowed to write a few min- 
utes only at a time ; by frequent breaks a good deal 
of writing may be finally performed. 

With these precautions, classes of young children 
may be drilled in the art of sitting up in a cor- 
rect form. In writing, it is safest to sit squarely 
facing the desk (for sidelong attitudes engender the 
corkscrew, spiral curve of the spine). The upper 
part of the trunk must be straight, the head bowed 
as little as possible; "the shoulder-blades, both of 
the same height, are, together with the upper arm, 
freely suspended on the ribs, and in no way support- 
ing the body ; both elbows on a level with each other, 
and almost perpendicular under the shoulder-joint, 
without any support ; only the hands and part of the 
fore-arm resting on the table." [Liebreich.] If lean- 
ing against the back of a chair in writing, some sup- 
port is naturally given to the elbow from behind. 

A child who is expected to write more than half an 
hour must have a full support for the back, at least as 
high as the shoulders. 

The same is true of piano-practising. There must 
be a back-rest and a foot-rest also ; the latter is easily 
supplied by a hassock or foot-stool. 

The point where support for the back is most 
needed, for work of moderate duration, is the sacrum, 
or bone on which the spinal column rests. This bone 
is curved, and the support given by the curve at the 



72 SCHOOL AND INDUSTRIAL HYGIENE. 

back of a saddle is exactly what should be found in a 
good seat. For weakly children, a support for the 
whole back is also necessary. 

For protracted work, also, unusual support may be 
said to be necessary. But there should be no pro- 
tracted work without breaks. 

The seat must be large enough to support the thighs 
for nearly their whole length. 

A "carved" seat, i. e., with a saucer-like hollow 
of elongated shape to sit in, saves much of the pain 
which comes from sitting on fiat boards. 

Settees are decidedly uncomfortable and unsuitable. 
They do not encourage sitting erect, for the backs are 
much tilted ; they do not support the bottom of the 
body properly, and the whole weight tends to slide for- 
ward ; they are not suitably carved, and press directly 
on the tuberosities, or bones that are sat upon. 

A foot-rest should be provided for several reasons. 

The term "distance" is technically used by the 
Germans to express the distance between the edge of 
the chair and the perpendicular line dropped from 
the edge of the desk. Authorities differ, even in 
Germany, as to what the distance should be ; but the 
most approved opinion seems to be that it should 
equal zero (the plumb-line grazing the seat), or a 
minus quantity (the line falling on the seat). Lieb- 
reich directs that it shall be zero for writing, and five 
inches for reading, which is unobjectionable, as his 



SCHOOL-DESKS AND SEATS. 73 

desk has a hinged lid which turns up, and assumes an 
angle of 40 for reading. He remarks that 

" If the child has to read a book placed on the 
table at too great a distance, it sits on the edge of 
the seat, a very unhealthy and fatiguing position. It 
rests the body on the two arms, and, if the difference 
between the [height of the] desk and seat is too great, 
the chest is supported by the projecting shoulders, 
instead of the shoulders resting on the thorax. Soon 
this position becomes too fatiguing ; the head, bent 
forward, becomes too heavy, and must be supported 
by one or both hands at the temples, or by the chin 
resting upon both arms. Thus every possible modifi- 
cation of the two positions immortalized by Raphael, 
in the two angels at the feet of the Sixtine Madonna, 
is adopted by the children ; but while the angels look 
into the far ether, our children stare into a book, 
which, in one of these positions, is only two or three 
inches from the eye ; and, in the other, sideways from 
the head, and therefore at an unequal distance from 
the two eyes. 

"It is still worse when writing; with desks and 
seats of the ordinary form, only one arm rests on the 
table — this is generally the right, while the left 
hangs so that the elbow approaches the left knee, 
and only the tips of the fingers hold the book on the 
table. The edge of the book is no longer parallel 
with the rim of the table, but slanting, or even per- 
7 



74 SCHOOL AND INDUSTRIAL HYGIENE. 

pendicular to it. If we observe the position which 
the upper part of the body assumes, we find that the 
lumbar vertebrae bend forward, those of the chest 
towards the left, and those of the neck forward, with 
an inclination to the right ; at the same time, the 
lower part of the shoulder-blade stands too far off 
from the ribs, and is elevated too much towards the 
right, and the shoulder-joint is raised and pushed 
forward. To be in such a position for several hours 
of the day, at a time when the youthful body is 
rapidly developing, must naturally produce bad re- 
sults." The author then speaks of spinal curvature 
as thus caused, and adds that "the period of the 
development of spinal curvature and short-sighted- 
ness coincides exactly; and they seem to form a 
circulus vitiosus, in so far as short-sightedness pro- 
duces curvature, and curvature favors short-sighted- 
ness ; while evidently the same bad arrangements are 
at the foundation of both these anomalies." 

The edge of the desk should be of such a height 
that, as the child sits upright and lets the arms fall 
freely, the elbows are about an inch lower than the 
edge. For girls, the desk may be one-half or three- 
quarters of an inch higher than this. 

It is a very common fault to furnish school-rooms 
with desks of only one size. The diversity of height 
among children, differing even only by two or three 
years, is such that three sizes ought to be kept in 



SCHOOL-DESKS AND SEATS. 



75 



each class of a "graded school;" and in a school 
of mixed ages, a larger number. To satisfy all re- 
quirements, eight sizes are needed, as indicated in 
the accompanying table, which is quoted from Var- 




Varrentrapp's school-desk and seat, as used by the youngest 
classes. 

This is adapted to all ages by changing the seat only. The 
dotted lines cf the seat give the position and dimensions which 
are suitable for the older scholars, who can dispense with the 
foot-rest. The distances^ i (36.4 centimeters) and /; i (5.2 cen- 
timeters) remain the same for all children ; the " difference," 
ip, is slightly increased for the older ones. 



7 6 



SCHOOL AND INDUSTRIAL HYGIENE. 



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SCHOOL- DESKS AND SEATS. "J J 

rentrapp. The table is especially valuable as giving 
the correct heights for the chair and the desk-lid, 
which are the chief factors (see columns 3, 4, 5). 
The edge of the lid overhangs the seat by about two 
inches. If the height of the chair is reckoned from 
the foot-rest, the latter is supposed to be .directly 
under the knees. The chair-seat is, in fact, much 
higher than is common in our schools, which en- 
courages the habit of keeping the knees at right 
angles. 

A rest may properly be placed under the desk. 
The figure represents a desk which raises the scholar 
a good deal (without interfering with comfort), the 
object of which seems to be to facilitate the master's 
inspection of the writing. 

To complete this account, it is necessary to describe 
the mode recommended by Liebreich.* 

1. One and the same size and model of desk 
should be used for children and grown-up persons of 
both sexes. 

2. The adaptation to the height of each child 
should be effected by varying the height of the seat 
and the foot-board. 

3. The edge of the table is always to be perpen- 
dicular to that of the seat. 

* " School Life in its Influence on Sight ; " a lecture delivered 
before the college of preceptors at the House of the Society of 
Arts, July 13, 1S72. London, 1872. 
7* 



78 SCHOOL AND INDUSTRIAL HYGIENE. 

4. No seat is to be without a back, and the top of 
this is always to be one inch lower than the edge of 
the table for boys, and one inch higher than the edge 
of the table for girls. 

5. In all classes where the boys change places, the 
height of the seat is to be regulated in proportion to 
the average height of the pupils. 

6. In all girls' schools, in all those boys' schools 
where the children do not change places, in boarding- 
schools, and in private school-rooms, the seat of each 
child should be accurately regulated in proportion to 
its height. This is effected by a chair, the seat of 
which can be raised and lowered by means of a screw, 
while at the same time the back is brought forward 
in proportion. 

The present writer would say that it seems to him 
very desirable to select seats that suit individuals, and 
allow them to retain such seats, instead of shifting at 
the monthly or weekly change of rank. There is 
also, in some cases, much advantage in placing the 
near-sighted, the partially deaf, or the unruly near 
the front. 



CHAPTER IX. 

A MODEL SCHOOL-ROOM. 

UNDER this heading, I wish to state a number of 
points which have various bearings on the health 
of scholars and teachers in an ordinary class-room. 

Shape. — For reasons which will appear, a parallel- 
ogram is desirable, with the teacher's platform and 
desk at one end. This form is better for acoustic 
reasons than a square ; and it gives the teacher better 
command over the pupils than if the desk is in the 
middle of one long side. 

Length. — The limit of distance at which large, 
clear writing on the blackboard is easily seen (with 
letters 2? inches in height) is about thirty feet. There 
should be a space between the rear row of desks and 
the wall, which may add two or three feet. The 
length of the room should, however, in no case ex- 
ceed forty feet (Erismann), and is limited by Var- 
rentrapp, Zwez, and others, to nine or ten meters (30 
to 35 feet). 

Width. — This is restricted by the fact that all the 
windows are supposed to be placed on one of the 

79 



80 SCHOOL AND INDUSTRIAL HYGIENE. 

long sides of the room ; and that these windows will 
not light up a room effectively if its depth exceeds a 
certain ratio to the height of the window. This ratio 
is commonly set as 3 to 2 ; so that if a window-head 
is fourteen feet above the floor (which is rarely the 
case), the light will penetrate effectively to a distance 
of twenty-one feet. Again, allow three feet for the 
width of the passage beyond the farthest desk, and 
twenty-four feet is seen to be the extreme allowable 
width; or, if the window is 13J feet high, about 
twenty-three feet. 

Height. — This is limited to thirteen or fourteen 
feet, by practical considerations, such as the expense 
of building and heating. 

Windows. — The direction from which light comes 
to the desk of a scholar is of great importance. It 
is universally agreed that for general purposes that 
which comes from the left is best. Almost all au- 
thorities of scientific weight order that this be made 
the rule, and, in fact, the Germans generally forbid 
the use of windows upon any other side of the room. 
It may be said that light from the right hand is as 
useful to read by as that from the left. This is true ; 
but in writing, such a light is very annoying. And 
a combination of lights from the right and left throws 
a double set of shadows, which is also trying to the 
eyes. The same may be said of a combination of 
light from the left and rear. 

The worst light, in general, is that from directly 



A MODEL SCHOOL-ROOM. 81 

in front of the scholar. It pains the eye, if intense. 
If moderate in amount, it still inflicts an unconscious 
strain on the retina, by throwing on it an illumination 
which would be healthful if the eye were not at work 
on small objects, but which is a needless tax on the 
endurance of the laboring organ. Practically, any 
one may prove that it is much harder to read with 
the book held towards a window than with the book 
held away. This difficulty is felt by the scholar, who 
tries to remedy it in his own way. 

Sometimes he holds the book closer to his eyes, 
which aids in developing near-sightedness. Some- 
times he twists his body around so as to receive 
the light on his book in the natural way, and this, 
if allowed, may contribute to " one-sidedness " or 
crookedness of figure. 

Windows in the rear, fronting the teacher, are very 
annoying to the teacher, and considerably lessen the 
power of watching the scholars ; while for the scholars 
they are exceedingly bad, as they throw the shadow 
of the person on the desk or book. 

The most agreeable light to write by is one which 
comes from a pretty high point, and strikes the page 
at a wide angle. An ordinary window will not give 
such a light, but may still be found very suitable if 
placed on the left of the scholars. 

.Light entering horizontally has hardly any value 
for a student who has to use a flat desk. The ex- 
F 



82 SCHOOL AND INDUSTRIAL HYGIENE. 

periment may easily be made by any one. Hence, 
the lower panes of windows are of little use as admit- 
ting light for study. The upper parts are by far the 
most important, because they throw light to the op- 
posite side of the room, and also light up the ceiling, 
which in reality is a principal source of light. By 
the use of iron beams, the window-heads may be 
brought within a few inches of the ceiling. 

The reader will easily see the objections to a semi- 
circular arrangement of the seats in a room (as is often 
the case in primary schools). It is not an advantage 
to the teacher to have to turn her head to the right and 
the left, as must be done if her chair is near the imagin- 
ary centre. Nor can such a group of seats be fairly 
lighted without throwing light directly in the faces 
of some of the scholars, not to speak of the teacher. 

The size of the windows, taken collectively, should 
equal at least one-sixth of the floor-space, and ought 
generally to be more. In the best American schools, 
it is very much more. 

Shades. — The best protection against a hot sun is 
furnished by Italian canvas screens. Common cloth 
shades, with rollers, are good ; they had better be 
rolled at the bottom. Shades with slats are better. 

White daylight, the unaltered light of white clouds, 
or the clear sky is better than colored light to work 
by; hence, there is no advantage in tinting the ceil- 
ing, or in giving it any other than a clear-white color. 
But the walls at which the inmates of the room must 



A MODEL SCHOOL-ROOM. 83 

be frequently looking, and which cast side-lights into 
the eyes at most times, may be tinted of a bluish, or 
semi-violet, or neutral hue. 

The blackboards should be so placed as to receive 
a good light. If put between windows, this is not 
the case, and the eye is fatigued bythe bright light 
at the side. 

Polished, brilliant, dazzling surfaces, or light-col- 
ored surfaces on which the sun is shining, should 
never catch the eye while at work. The floor should 
be dark and without polish. The sun's rays should 
never fall on the scholar's work. 

Artificial light has to be used in some cases. It 
should be given by powerful burners at a considerable 
distance from the pupils. Ground-glass is bad for 
shades. Ground or ribbed glass is bad for windows. 

Gas-light is a very good illuminator when the gas 
is good. But there is a great deal of an injurious 
substance given off in burning, chiefly consisting of 
sulphurous acid, which ought always to be got rid of 
by a special ventilating-cap and flue applied to the 
gas-flame, so arranged as to lead the spoiled air 
straight to the house-chimney before it can mingle with 
the air of the room. The tube may be so managed 
as to have a powerful ventilating action on the at- 
mosphere of the room, also. 

Decoration. — The sun is the best decorator, and 
should be let in when this is consistent with other 
points. Flowers, plants, colored prints, light and 



84 SCHOOL AND INDUSTRIAL HYGIENE. 

pretty wood for desks, give an impression of great 
cheerfulness, which it is very desirable to maintain 
in the interests of health. The lower part of the 
wall may be wainscoted, to preserve it and facilitate 
cleaning. Wall-paper should not be used ; the walls 
should be finished with a material that can be cleaned 
or else whitewashed. 

Architectural ornament is the last thing to be 
thought of in a school-house, which should be built, 
first and foremost, to do its work well — as we build 
a locomotive-engine. "Architecture," i. e., con- 
siderations of external appearance, may be considered 
a foe to the health of school-children when it is 
allowed to absorb school-funds to the neglect of 
essential internal parts. The use of flanking projec- 
tions, buttresses, pointed arches, or other features 
which cut off portions of light, is to be condemned 
entirely; the exterior appearance of a school-house 
must necessarily be rather plain in certain respects. 

Closets. — The children's outer clothing and um- 
brellas should not be kept in the class-room, to pollute 
the air with their steaming exhalations. A closet 
must be provided with space enough for each child's 
clothing to hang free of the next one's; and the 
closet should be warmed, lighted, and ventilated. 
Its position will naturally be near the class-rooin in 
ordinary cases. 

The floor should be of hard, close-grained wood, 
of a kind which will not easily splinter. 



CHAPTER X. 

VENTILATION AND HEATING. 

IT is impossible to do justice to either of these 
subjects separately. The air breathed must be 
warmed for a large part of the year. The warmed 
air must be got rid of by ventilating apparatus, which, 
again, is often in close relation with that for heating. 
The annual bills for heating and for ventilation de- 
pend equally on the price of coal. In practice it is 
found that, unless planned to work together, the 
"system" of ventilation often contradicts the "sys- 
tem" of heating, and vice versa. Need we speak of 
careless masons, carpenters, and tinsmiths, who ren- 
der the best plans of the sanitary engineer void and 
of none effect ? 

In a word : All heating apparatus, with trifling ex- 
ceptions, ought to be apparatus for supplying fresh 
air. It is impossible to consider the problem of in- 
troducing air without considering that of discharging 
it. It is absurd to hire one man to get the air into a 
room, and another to get it out. And yet this is 
practically done in assigning contracts. 

8 ' 85 



86 SCHOOL AND INDUSTRIAL HYGIENE. 

It is not necessary that the same party should do 
all the work, but that the different parties should be 
controlled by one authority. 

Quality of the Air. — It is well to have the inlet of 
the air-duct for a furnace protected from the more 
violent winds. It is very desirable to place it at 
a sufficient height (say ten or twelve feet) from the 
ground, in order to avoid low-lying strata of polluted 
air. The neighborhood of privies is certainly not a 
desirable one ; yet even this circumstance may exist, 
as was recently the case in a school in one of the 
large northern cities, with most disagreeable results. 

The furnace ought not to leak gas. As a rule, the 
draught is constantly inward towards the fire and 
smoke, so that, even if there are small cracks in the 
furnace or flue, there is no discharge of gas. It is 
unsafe to have a valve in the flue above the furnace. 
Some valves are expressly made so as to shut only 
half-way, or to leave half of the flue always open ; 
but it is better to regulate the draught, if necessary, 
by dampers to the inlet of air under the fire-pot. 

A large furnace is best, — one large enough never 
to need to be made red-hot. Slow combustion is 
economical; but, much more than that, it seems to 
supply an air which has not been "killed" or 
"burnt." A little very hot air is known by expe- 
rience to be distressing, when a large supply of air 
heated only to about 90 is perfectly pleasant. The 



VENTILATION AND HEATING. 87 

discomfort is due to the want of fresh air ; partly, 
also, it may be, to a chemical action of the red-hot 
iron on the air, or the transit of carbonic oxide. 

The addition of a liberal amount of water by 
evaporation, in dry, cold weather, is a necessity. At 
least, some people are very unpleasantly affected by 
air that is not so treated. Nevertheless, there are 
hospital-wards (as in the City Hospital at Boston) 
heated by the simple introduction of abundant sup- 
plies of fresh air that is simply warmed, and not made 
moist ; and the result seems eminently satisfactory. 

" Indirect radiation " is a term used for those cases 
where air is heated at a central point and conveyed 
in pipes to the rooms. "Direct radiation" is the 
use of radiators in the rooms ; it generally implies 
the absence of means for introducing fresh air, and 
as such is objectionable, unless for heating entries or 
very exposed points. 

Apparatus for heating by steam or by hot water are 
generally to be praised. The great point to attend 
to is, that the air be not heated in excess. 

Stoves have several objectionable pofnts. In the 
first place, they overheat a part of the room, and 
leave other parts cold. This is obviated in a degree 
by a screen. But a still more important objection to 
most stoves is the want of a method for introducing 
fresh air. Almost any ordinary stove can be altered, 
however, at moderate expense, so as to give a large 



88 SCHOOL AND INDUSTRIAL HYGIENE. 

supply of fresh warmed air. The "fire on the 
hearth" is an example of the way it is done. A 
cylindrical metal screen may be placed around the 
stove ; it should reach to the floor, and rise as high 
as the stove. Under the floor a pipe is to be led 
from the space enclosed by this screen to the outer 
air; the pipe passes through the house-wall, and may 
have a valve at any convenient place. This converts 
the stove into what is commonly called (when placed 
in a cellar) a "portable furnace" with "hot-air 
box." The fresh air enters the room over the top of 
the screen. This plan removes the objections which 
attach to air-tight stoves. 

Further use may be made of the stove-funnel by 
causing it to warm another tube which serves for ven- 
tilation only. Thus, the smoke- funnel may be en- 
closed in a larger pipe, which is not closed either 
above or below, but, starting at a proper point in the 
room, rises with the funnel through the roof, and 
discharges its own quantum of impure air sucked 
from the room. 

If the chimney-place is bricked up, a hole may be 
knocked in the brick-work, or at a higher point in 
the chimney. 

A fire in a fireplace in an ordinary city house 
may be supposed to exhaust enough air from a room 
to make it wholesome for ten persons. If several 
gas-jets are burning, this is no longer true; for a gas- 
jet of the ordinary kind spoils as much air as two or 



HEATING AND VENTILATION. 89 

three persons. Of course, an open fire is but a par- 
tial means of ventilation for a large school-room, 
besides being very wasteful of fuel. 

The requirements for good ventilation in a school 
are, that the air shall be furnished in a fresh volume 
of from 40 to 100 cubic meters (1400 to 3500 cubic 
feet) hourly to each scholar. If the room is spacious, 
there may be 300 cubic feet of space per scholar, so 
that the whole air-contents of the room are required 
to be evacuated from five to twelve times an hour ! 
while, if the room is of moderate size, say 200 cubic 
feet per head, the change must go on faster — the en- 
tire contents must be changed once every %\ minutes ! 
And this can be done, and is done, without causing 
a draught. But we can see at once, that if the room 
is crowded, and the air is wholly changed once in /our 
minutes to correspond, the draught will be great. A 
closely-packed room is not well ventilated for just 
this reason; the inmates cannot bear the draught. A 
certain amount of "elbow-room " must be given, or 
the air-currents will not be borne. There should be, 
therefore, about fifteen square feet of floor-space for 
each inmate of the room, or from fifteen to twenty. 

These considerations lead directly to a fact which, 
though it stares us in the face, is seldom fully compre- 
hended ; that fact is, the expensiveness of ventilation. 

Every house requires a considerable amount of heat 
to keep its walls warm. Let the house and contained 



90 SCHOOL AND INDUSTRIAL HYGIENE. 

air be raised to 70 , and let the supply of heat from 
the furnace be cut off, the whole amount will pass 
away through the walls in a day or two. This is 
a necessary waste ; or at least it can only be dimin- 
ished by furring and thickening the walls and by 
doubling the windows. But to extract every eight 
minutes a school-houseful of freshly heated air, and 
send it up over the ridge-pole, would seem extreme 
folly to any one unacquainted with the facts and the 
necessities of the case. This is not the place to ex- 
plain these necessities ; suffice it to say that the school- 
house is a peculiar place, a very closely packed place, 
and subject to those peculiar morbid influences which 
attend the close packing of human beings, and which 
are so distinctly proved to exist, that the death-rates 
of different cities are high or low in proportion to 
the number of people dwelling on the square acre. 
Fortunately, we have it in our power, by the judicious 
arrangement of flues and the liberal use of coal, to 
render these school-rooms as wholesome as the aver- 
age dwelling-house. I do not say that this is gen- 
erally accomplished, for it is not, even in enlightened 
cities. 

In a large school, with a thousand or more pupils 
(though it is certainly undesirable to have even as 
many as a thousand), a system of flues leading to a 
heated chimney is often used to carry off bad air. If 
the draught in this chimney could be maintained by 



HEATING AND VENTILATION. 9 1 

a little steam-engine and fan, an economy in fuel 
could doubtless by made, and the experiment should 
be tried in some school where there are already steam- 
boilers. 

The janitor, under proper oversight, may be made 
to feel the importance of his duties, and the impro- 
priety of those customary negligences by which he 
saves himself trouble and lessens the amount of coal 
burned. If lie be found incapable of taking a proper 
pride in his duty, he should be replaced by another. 

One point is seldom conceded by this class of men. 
The cellar air is their native element, and they sel- 
dom realize that it is an impure element. They do 
not practically know that cellar air is generally un- 
suitable for the supply of the furnace air-box. If 
not prevented, they will at times close the outer orifice 
of the duct, and open a slide which admits the cellar 
air into the furnace box. It can rarely be safe to do 
this. 

There are certain contrivances for letting fresh air 
enter a room unwarmed without striking the scholars. 
One of the best and simplest is to place a narrow 
piece of wood under the lower sash. The effect is to 
leave a narrow opening between the sashes, which 
admits air in an upward direction. 

Another plan is to use a wider board, and pierce it 
with one or two wide pipes bent at right angles and 
provided with valves ; this, also, throws the wind 



92 SCHOOL AND INDUSTRIAL HYGIENE. 

upward. This is called the "Maine" ventilator. 
Sometimes it is modified by covering the inlet with 
tin, perforated with fine holes. The object of doing 
this is to prevent the inflow of a great volume of air 
in the form of a draught ; but it really shuts out about 
three-quarters of the air. Then there is a contrivance 
for letting air enter through a sifter of cloth, in the 
upward direction ; but the cloth can easily be per- 
ceived to lessen the ventilating effect most essentially. 
A better method for sifting the air (because simpler 
and cheaper) consists in simply tacking very thin 
flannel to a mosquito-frame, in the place of gauze, 
and inserting the frame as is usually done. If it is 
thought desirable, both sides of the frame may be 
thus covered. The plan is found effectual. 

Dr. Keen, the editor of this series, " tacks or pins 
a piece of cloth or newspaper across the lower ten or 
twelve inches of the window-frame and to the win- 
dow-sill ; then raises the lower sash one inch to six 
inches, according to the weather. By this means, 
the draught is made to pass in the upward direction, 
both from between the two sashes and from the open- 
ing beneath the lower sash." * 

These inlets for fresh air, however, will not always 
let air pass. On a "close day," when there is no 
wind, even wide-open windows will, not sufficiently 
ventilate a room full of people. If windows are 

* See " Winter and its Dangers," Health Primer in this series, 
by Dr. Osgood, in which these various plans are illustrated. 



HEATING AND VENTILATION. 93 

placed on two sides of a room, ventilation is much 
more likely to do good ; if on opposite sides, all the 
better ; but in school-rooms there is an objection to 
this plan, owing to the interference of the light. The 
true value of these window arrangements seems to me 
to depend on the existence of a chimney or other 
similar draught-compeller in the room. If air is 
sucked out by the flue, air will readily enter by even 
small openings in windows; but if not, a window 
opened a foot or two will often have but little effect. 

Temperature. — It maybe proper here to call atten- 
tion to the disturbing effect which excessive heat has 
on the circulation in the brain, especially when the 
air at the floor is cold and the air at the level of the 
head is hot. A temperature of sixty-five is agreeable 
to healthy children, if they have an occasional chance 
to stir themselves, and if their clothes are dry. Sev- 
enty should not be exceeded ; and it is desirable that 
no two parts of the room should differ more than two 
degrees (2° Fah.). 

Wet clothing must not be allowed to remain on the 
scholar's person. This must be an imperative rule, 
enforced by the teacher's personal attention. 

It is hardly necessary to mention colds in the 
throat, head, and lungs as favored by such neglect. 
It is, however, easily forgotten that catarrhal affec- 
tions of the eye and ear, producing impaired sight 
and hearing, and menstrual irregularity, are also 
liable to be caused or aggravated by such neglect. 



CHAPTER XL 

SITE, DRAINAGE, ETC. 

SITE OF HOUSE.— This should be as healthy as 
possible. The character of the sub-soil should 
be known, in order that proper precautions may be 
taken against dampness, if clay, hard-pan, or rock 
forms an obstacle to natural drainage. 

Some protection from the north winds is desirable ; 
but the bottom of a valley, or low-lying ground, is 
generally objectionable. 

The plan should be such that the sun may enter 
every room of the house in the winter as well as 
summer. 

The lot ought to include play-grounds in the city; 
at the least, there should be space enough about the 
house to allow sufficient light to enter the windows. 
This requires a considerable outlay for land, which 
seems to be regarded as superfluous in some large 
cities. In the recent competition between plans for 
model schools, at New York, this point was forced 
upon the notice of the committee of award. In their 
report, they claim that a public school building in a 

94 



SITE, DRAINAGE, ETC. 95 

large and densely populated city should not occupy 
more than half the lot ; and that, further, " at least 
two adjoining sides of the building should be freely 
exposed to light and air ; for which purpose they 
should be not less than sixty feet distant from any 
opposite building." 

The terms of competition in this case were, that 
the house should accommodate eight hundred chil- 
dren, and should be built on a lot one hundred feet 
square, facing north, enclosed by buildings of average 
city height on the other three sides. As a result of 
the competition, it appears to the committee that 
such a house cannot probably be built on such a lot 
consistently with the requirements of health. The 
children can be provided for, but the light will prob- 
ably be defective in many rooms even with the best 
arrangement. 

Height of House. — One of the points to be aimed 
at in the sanitary reform of schools is a reduction in 
the height of buildings. A strict system of drill 
may prove the surest precaution against accident in 
case of fire, and deserves to be kept up. But there 
are many children — particularly girls — who ought not 
to be required to ascend many stairs. In the course 
of a forenoon, several lessons may have to be recited 
in different parts of the house, with going up and 
down ; and the recess or recesses are, or ought to be, 
taken in the school-yard. Decided injury from exer- 



96 SCHOOL AND INDUSTRIAL HYGIENE. 

tion of this sort occurs in occasional cases ; and it is 
a disadvantage to any girl to be placed so high that 
she is unwilling to take the trouble to go out of doors 
at recess. 

Sewerage. — It is doubtful whether privy accommo- 
dations, or water-closets, for a large school, can safely 
be placed in the cellar. There will pretty surely be 
a nuisance of greater or less extent, which is much 
more serious than if it existed on an upper story, or 
in a yard, since the air of cellars must rise more or 
less into the house. If the plan be tried, let all pre- 
cautions be taken : if water-closets are used, they 
should not be of the pan variety, but rather hopper- 
closets, or some form made entirely of earthenware, 
and should provide a rapid, abundant discharge of 
water; if urinals, they should contain no wood-work 
in any place which can be reached by spattering, and 
should be made of impervious stone or glass— not 
metal. A long trough of masonry, kept partly full 
of water, is a good substitute for water- closets. Some 
closets should be placed on the different stories, in 
any case. It is far the best if the whole can be put 
in a tower, semi-detached and accessible from every 
story of the main building. 

A correspondent from a distant city writes as fol- 
lows : " From considerable observation and inspec- 
tion of the public schools, I am sure that the water- 
closets, on the boys' side at least, are as filthy as they 



SITE, DRAINAGE, ETC. 97 

can be ; so filthy, in fact, that no decent boy can or 
will use them." This state of things is familiar to 
me as a reminiscence of childhood ; at present my 
observation, confined to the city of Boston, points to 
a very great improvement, seconded in many cases 
by the very anxious care of the masters. But in 
many cases there is a truly shocking state of things, 
descending in one case, reported by a correspondent, 
to the use of a common waterless privy in the second 
story of a school, while in country places there are 
numberless cases of shameful neglect. The old-fash- 
ioned plan, which allowed all the excrement to lie in 
a heap on the surface of the soil, is by no means the 
worst of all these. Where earth is plenty and waste 
land near by, there is no excuse for not "sanitating" 
the privy by throwing in a layer of fresh dry loam once 
in a week or two so as to cover up everything, and 
removing all the contents together, and burying them, 
every two or three weeks at longest. This plan, if 
faithfully pursued, will almost entirely destroy odor. 
9 G 



CHAPTER XII. 

PRIVATE SCHOOLS. 

A FEW points may be added of special application 
to boarding-schools and private day-schools. 

Both classes of schools are very often held in com- 
mon dwelling-houses, very slightly changed by adding 
an L, or something of the sort. 

Dwelling-rooms and parlors are very often not pro- 
vided with windows sufficient to light them well for 
school purposes. They are, unfortunately, often not 
provided with fireplaces — an unpardonable fault. 

As regards light, much may be done to improve 
matters by using light colors for walls ; by whitening 
the ceiling; by cutting down trees in front, and re- 
moving drapery-curtains within. 

A room with ten or a dozen pupils may be made 
comfortable (as regards the freshness of the air) by 
an open fireplace. For a larger number there are 
needed special arrangements for ventilation, such as 
openings in the flues at ten feet from the floor and at 
the floor; or tin tubes, heated by one or two gas- 
jets, acting as flues. 

98 



PRIVATE SCHOOLS. 99 

It is, of course, desirable not to let more than two 
pupils sleep in one ordinary room. A great deal of 
crowding, however, of a very reprehensible sort, may 
be found in boarding-schools. Under ordinary cir- 
cumstances, 1000 cubic feet of space should be allowed 
for one person to sleep in. 

The purity of the air depends on many external 
circumstances. A house with many windows, on a 
corner lot, with free exposure to wind and sun, and 
not very solidly finished in the wood-work, is likely 
to have much more and better air than one in a nar- 
row street, with the rear built around. Old houses 
are often musty ; I will not say incurably so, but their 
atmosphere is commonly tolerated rather than that 
trouble should be taken. 

Dormitories should be strictly supervised. A 
teacher should regulate, or oversee, the admission of 
air by windows at night. A good dormitory for boys 
may be made of a long room, with a row of small 
compartments on each side, each containing a bed 
and a window ; the partitions, not permanent but 
screens, not exceeding six feet in height, and the 
doors consisting of curtains. Ventilation by open 
windows at the ends may be safely practised in the 
case of healthy young folks. 

Supervision should be exercised, also, in the inter- 
ests of morality. Licentious practices are certain to 
be introduced, unless this is done. A late distin- 



IOO SCHOOL AND INDUSTRIAL HYGIENE- 

guished hygienist assured me, that in a boarding- 
school which he attended, he was sure that all the 
boys but one or two were guilty of such practices ; 
and he added that this was not an exceptional 
school. But a very great deal can be done, by mas- 
ters who are themselves of pure lives, in checking 
such tendencies. Teachers, and especially parents, 
can do incalculable good by suitable explanations to 
pupils of say twelve years and upwards, who sin far 
oftener from ignorance than from vice. 

Perhaps less needs to be said in regard to girls ; 
but it is well known that vicious persons occasionally 
enter the best establishments, and that the love of 
imitation misleads even those whose behavior and 
general intentions are good. 

It may be superfluous to say that girls at a board- 
ing-school need that kind of care which mothers 
should give. It may be safe to let steady young 
women of sixteen or upwards go to large colleges for 
girls ; but younger girls, in my opinion, ought not to 
be placed in large schools away from home. The 
tranquillity, the absence of exciting influences, or at 
least their absence during a greater part of the day, 
which prevail in a well-ordered house, are necessary 
at that age, if ever, in laying the foundations of a 
firm and steady nervous system. The constant 
presence of scores or hundreds of other girls, some 
critical, some vindictive, some too demonstratively 



PRIVATE SCHOOLS. IOI 

friendly, is a strain upon the nervous system of s 
child. 

Children ought to have some hours in the day in 
which to do exactly what they like, inventing their 
own amusement, and laughing as loud as they will. 

Boys should have a good gymnasium, and, in 
the country, place and means for out-door games. 
Girls should be obliged to have proper shoes (heels 
not over half an inch high), and should be let out (or 
led out, if necessary,) to walk twice a day; they 
ought to learn the habit of walking while at school. 

Music is a fatiguing occupation ; if the scholar is 
fond of it, it is not less an exertion, and should not 
be carried far (say not over an hour a day of prac- 
tice) without a corresponding reduction of study. 
And no prolonged practice should be allowed without 
suitable breaks, in accordance with general principles 
which have been fully explained. 



CHAPTER XIII. 

COLLEGES. 

IT may be questioned whether college students should 
be included in a work on "school " hygiene. They 
are, however, very largely under age and in the grow- 
ing period. The average age at entrance in the best 
colleges is about nineteen. In the Amherst statistics 
it appears that during the four college years they 
grow in height 1.3 inches and in weight 11.1 pounds. 
The two lower classes, at least, are of the age which 
breaks down in military life. They are unformed, 
unconsolidated, and none know better than the au- 
thorities of colleges how ductile their minds are in 
certain directions not laid down in the curriculum of 
study. 

The inference from these remarks is plain : the 
students must not be left to themselves in physical 
matters. The younger classes, at least, should be 
compelled to attend regular exercises in gymnastics 
under the charge of some respected person. The 
title and position of professor may confer that re- 
spect, or distinction as an athlete and an ingenious 

102 



COLLEGES. 



I03 



inventor of apparatus may give it ; but a mere prize- 
fighter or trapezist is not likely to do well. He should 
be chosen with the same care as a professor in Chinese. 

The exercises required of a whole class must, nec- 
essarily, be such as fall far within the capacity of 
some. They should include a brisk run, free-hand 
exercises, and exercise with wooden dumb-bells or 
light clubs. The class is divided into sections, each 
under the lead of a student. There is no reason why 
a hundred or more should not exercise at once in 
this way, with the assistance of music. Thirty or 
forty minutes a day is sufficient for the purposes of 
health for most students. Those whose larger mus- 
cular development craves more work should be put 
into special classes or allowed to use all kinds of 
apparatus, but always under the general control of 
the teacher. There will be students who could be 
trusted with instructing classes, but most of them 
have a propensity to lame themselves, and get dis- 
couraged over the hardest apparatus the moment they 
first enter the gymnasium ; and, in short, nine-tenths 
of them are no more fit to be trusted alone than little 
boys are with firearms. 

The use of the gymnasium is a necessity for those 
who intend to do boating. The latter exercise, as 
performed in swift shells, has very little tendency to 
develop the chest. It brings a great and sudden 
strain on the heart and lungs, which is very likely to 



104 SCHOOL AND INDUSTRIAL HYGIENE. 

be injurious in either of two cases: first, if the boy's 
frame is below a certain minimum of development ; 
and, second, if, being of fair natural growth, he is 
not specially trained to chest -power — the capacity of 
the lungs and heart to receive a double amount of 
air and blood in a given time. The pulse of oars- 
men after a race beats at twice the normal rate, and 
a long and careful training alone can make such a 
strain safe. If boating is to be encouraged, — and I 
believe it should be, — a gymnasium is a necessity. 

It is a great benefit to the students to have good, 
substantial "commons" provided for them. This is 
done at Harvard in a very satisfactory manner and at 
exceedingly cheap rates. Many students injure their 
health by "boarding themselves" in their own rooms, 
and this class especially need such a public provision. 

In regard to the structure of college dormitories, 
it would be well to place them running north and 
south, so that the sun shall enter every window. For 
further remarks on the site of buildings, see Chap- 
ter XI. 

The public have been recently excited at the fatal 
epidemic in Princeton College. There is nothing at 
all new in such an event; and if instructive, it is so 
only in one point, namely, that filth generates disease 
in seminaries of learning as readily as in New York 
tenement-houses. 



CHAPTER XIV. 

CONTAGIOUS DISEASE. 

IF a person residing in a school is attacked by small- 
pox, varioloid, scarlet-fever, measles, diphtheria, 
or any contagious disease of the eye or skin, such 
person should at once be removed or absolutely 
isolated. It should be left to the judgment of the 
physician to decide whether such isolation shall be 
considered sufficient to permit the other scholars to 
remain. Such may be thought the case if the school 
is in the country and has a separate building for an 
hospital. It may be thought safe for day-scholars to 
come (e. g., to the rooms in the lowest story, while 
the patient is in the top of the house) ; but, in gen- 
eral, prudence will lead to a suspension. 

After recovery, thorough disinfection of the room 
used by the patient is accomplished by burning two 
pounds of sulphur. Previous to doing this, all bed- 
ding is exposed as much as possible by spreading it 
on chairs, etc. ; and the windows and doors are 
closed tightly. The wood-work in the room, of all 
sorts, is then to be sponged repeatedly with solutions 
of chlorinated soda or carbolic acid. 

105 



106 SCHOOL AND INDUSTRIAL HYGIENE. 

In the case of public schools, the following rules 
are suggested : * 

"A certificate of vaccination to be required of every 
child entering the public schools. 

"Physicians to be required, under penalties, to re- 
port to local boards of health all cases of dangerous 
infectious diseases observed by them ; the board to 
inform principals of schools. 

" The existence of any case of such diseases in a 
house to exclude the inmates from attendance at 
schools for a sufficient length of time, the propriety 
of re-admission being certified to by a competent 
physician. 

"Disinfection of premises and clothing by the 
board of health in every house where the above dis- 
eases have prevailed. 

"Medical authority to be designated, for the purpose 
of advising teachers and pupils, and pointing out to 
the school committee matters in regard to which their 
authority might be used to improve the sanitary con- 
dition of schools." 

* See " Massachusetts State Board of Health Report," 1878, 
page 252. 



PART II. 
INDUSTRIAL HYGIENE. 



CHAPTER I. 

INJURIOUS EFFECTS OF INHALING DUSTY AND 
POISONOUS SUBSTANCES. 

IN the present brief sketch an attempt will be made 
to present some of the principal injuries which are 
inflicted on workmen in various trades by the noxious 
character of their work. Some remarks will also be 
made upon the number of hours of labor in occupa- 
tions which are not of themselves especially un- 
healthy; upon accidents from machinery; and, in 
conclusion, upon the "expectation of life" in differ- 
ent employments. 

The present chapter has to deal with a large num- 
ber of trades, and many striking facts. 

Among those which have excited most sympathy — 
and which in truth are adapted to do so — are those 
relating to the deadly effects of certain kinds of dust 
upon the lungs. The form of consumption which is 

107 



108 SCHOOL AND INDUSTRIAL HYGIENE. 

thus produced is apt to begin gradually ; though in 
some trades the artisan is affected in a few days. It 
is not exactly what is known as tuberculous consump- 
tion, for it is said that it is not hereditary, and that 
workmen who are suffering in its early stages are pretty 
sure to recover if they change their employment for 
a healthful one. There are a great many kinds of 
dust inhaled, and the effects are not all alike in the 
different trades ; but, in general, there is a certain 
set of symptoms. 

In "grinders' asthma," for example, there is first 
an irritant, hacking, dry cough, with a scanty expec- 
toration of whitish, stringy mucus, from simple irri- 
tation of the interior of the lungs. This trouble in- 
creases in time, and the man becomes weaker, loses 
his breath easily, and breathes with less vigor; he 
perhaps begins to spit a little blood. If he leaves 
his dangerous trade at this point, he will probably 
recover ; if not, he passes into a third stage, where 
the tissue of the lungs breaks down in spots and is 
expectorated, leaving cavities ; he then suffers from 
the usual symptoms of consumption, viz. : hectic 
fever, night sweats, loss of sleep, emaciation, and 
great difficulty of breathing. 

The effect of certain occupations in producing 
consumption may be estimated by the statement that, 
while among butchers, tanners, glovers, coopers, and 
brewers only from 7.9 to 11.2 in 100 have consump- 



INJURIOUS INHALATION. IO9 

tion, brush-makers have 49. 1, file-cutters 62.2, needle- 
polishers 69.6, and flint-workers 80, in 100. These 
figures represent European experience, and are taken 
from a large number of workmen of all classes enter- 
ing a large public hospital in Berlin. Expressed in 
words, they'signify that while consumption is, unfor- 
tunately, a common disease, and may be expected to 
destroy ten per cent, of the population (more or less), 
there are certain trades so terribly noxious by the 
production of irritating dust, that those who work at 
them have consumption from five to eight times as 
frequently as is usual in other trades. 

It is fortunately the case that great relief can be 
given by mechanical appliances for carrying off the 
dust formed in the process of grinding. The stone 
is boxed in and connected with a flue, which rapidly 
exhausts the air and its dusty contents from the sur- 
face of the stone. Several stones can be connected 
with one common flue in this way. The draught is 
produced by a fan driven by a small engine of eight 
or ten horse-power. 

Articles which can be ground wet, as knife-blades, 
scissors, etc., do not produce this trouble to such an 
extent ; but the artisan is liable to rheumatism and 
pneumonia from the wetting of his clothes. 

Certain articles must be ground dry, owing to the 
necessity of carefully avoiding rust in the finishing 
process, as in the case of pins and needles. The 
10 



IIO SCHOOL AND INDUSTRIAL HYGIENE. 

more extended use of machinery, however, in grind- 
ing, has of late done away with most of the injury 
from this form of dust. 

File-cutters are still exposed to injury from inhala- 
tion of particles. You know that machinery is used 
to make files ; but a better article is turned out by 
hand. 

Stone-cutters, especially cutters of mill-stones, suf- 
fer greatly from this kind of consumption ; and so do 
potters. In grinding the materials for earthenware 
and porcelain and glass, a great deal of the most in- 
jurious dust escapes. 

In preparing cotton for use in the mill by beating 
and carding, a vast amount of dust is generated ; but 
a proper arrangement of draughts ought to remove 
the danger of inhalation. 

The breathing of coal-dust in the process of mining 
changes the color of the entire lung in a few years to 
jet-black. This blackening of the lung is not con- 
fined to colliers, however, for it is always found in 
post-mortem observations of adults, to some extent, 
in patches of lung-tissue, and seems not to produce, 
ordinarily, any kind of disturbance. There seems, 
however, to be no doubt that, when in excess, it may 
injure a miner's lung, or, at all events, may aggravate 
other diseases. Provision is commonly made for 
ventilating mines, which affords considerable relief 
to this evil. 



INJURIOUS INHALATION. Ill 

The chief poisonous substances used in the arts 
and inhaled in the form of dust are arsenic, mercury, 
and lead. 

In the present state of popular knowledge, little 
need be said of the effects of arsenic in wall-papers. 
It is quite generally known that almost all shades of 
color are producible by arsenical preparations, and 
that such are actually among the most popular for 
producing the favorite neutral tints of the day, — 
green paper being scarcely more dangerous than any 
other. It is not the workmen, however, but the cus- 
tomers, who seem to suffer from contact with the 
arsenical colors; at most, they have certain cuta- 
neous eruptions and ulcerations. 

It is said to be very hard to bring foreign paper- 
makers to terms on the subject of arsenic. There are 
importers who faithfully try to prevent the use of such 
arsenical pigments ; and it would be just to second 
their efforts by legislative action forbidding the use 
of arsenical wall-papers altogether. But it will not 
be found an easy task to overcome the indifference 
of public men to mere considerations of health. 
Very few persons die of this sort of poisoning, it is 
true. Instead of dying, the unhappy victim (who is 
usually unaware of the existence of such a cause) only- 
drags out years of wretched invalidism ; and, at last, 
if removed from the injurious influence, is only ruined 
in health for the rest of life. .. .. 



112 SCHOOL AND INDUSTRIAL HYGIENE. 

The symptoms of poisoning from arsenical wall- 
paper are quite various. They include soreness of 
the eyes, catarrh of the nose, throat, and lungs, dys- 
pepsia and bowel-complaints, eruptions on the skin, 
and great general depression and debility. It is often 
noticed that the sufferer is much worse in the morn- 
ing, after a night spent in the poisonous room. The 
danger is greatest when the colors can easily be 
brushed off, and is least when they are protected by 
a glazing. But it is impossible to say when danger 
begins; and no arsenic should be allowed. 

A variety of the papers used for kindergartens 
has been found to be highly charged with arsenic. 
There is a green, very popular for this purpose, which 
almost betrays itself. Can it be necessary to insist 
that children of the age of four years should not be 
allowed to handle freely so dangerous a substance? 

It is perfectly true that many escape. The same is 
true of all contagions and poisons, from yellow fever 
to the lead contained in drinking water. It is neces- 
sary to take such measures as will protect those who 
are susceptible, who are likely to be among the most 
valuable members of the community. Before wall- 
papers are purchased, it would be well to have them 
examined for arsenic. Any chemist, or indeed any 
intelligent doctor, can easily detect them by Reinsch's 
test, at least. 

An eruption of the legs, painful if not dangerous, 



INJUR IO US INHALA TION. 1 1 3 

has been known to be produced by wearing stock- 
ings dyed red with coralline, a substance which may 
contain arsenic. 

Artificial-flower makers are exposed to the poison 
of arsenite of copper or the arsenite and acetate 
of copper — Scheele's and Schweinfurth green ; they 
inhale it, and receive it by contact with the skin. The 
effects are, characteristically, enfeeblement of the 
muscular force, especially of the limbs; also a loss 
of appetite, palpitation, pain in the stomach, diar- 
rhoea, and constant headache. 

Mercury is used by hatters to remove hair from 
skins. A solution is applied to the skin, and, after 
drying in a chamber, the hair is got rid of by beating or 
brushing, which liberates a great deal of some mer- 
curial compounds. The effects upon the health are 
those of chronic poisoning, of which one of the most 
prominent is that nervous complaint called mercurial 
trembling. 

Mirrors are silvered with an amalgam of mercury 
and tinfoil, which when heated parts with the mercury 
in the form of vapor. The process is so very inju- 
rious that in a certain French manufactory the work- 
men worked only six hours in a day, and only on two 
or three days in a week. The remedy for the trouble 
consists in abolishing mercury and coating mirrors 
with silver. A palliative has been found, consisting 
in the sprinkling of ammonia on the floors. 
10* H 



114 SCHOOL AND INDUSTRIAL HYGIENE. 

In fire-gilding, mercury and gold in the form of a 
paste are applied to the surface, and the mercury vol- 
atilized by heat ; this gives a much more solid and 
enduring surface than electro-plating, and the danger- 
ous steps of the operation can now be conducted in 
closed boxes. 

Both mercury and arsenic are driven off by heat 
in the process of roasting certain ores. Mercury 
seems to be very much the more dangerous to the health, 
causing sore mouth, loss of teeth, general debility, or 
"cachexia," acute pains, sleeplessness, spasm and 
tremor, and paralysis of the muscles, and intellectual 
feebleness, besides some symptoms resembling those 
of syphilis, eruptions, swellings over the shin-bone, 
and glandular enlargement, with deep ulcers of the 
mouth and nose. Altogether, the occupation of those 
who are forced to inhale mercury is one of the very 
worst. 

Lead is a very common poison — one of the most 
common. Its poisonous effects are felt by workers in 
lead-mines, by painters, by those who grind and pol- 
ish flint glass containing lead, by enamellers, and to 
some extent by type-founders and printers. Those 
suffer most who have to do with the process of dry- 
grinding colors. The "body" which lead gives is 
so much thicker than that of zinc that the latter does 
not supersede it. You may have seen cases of the 
colic which occurs in lead-poisoning. There is an- 



INJURIO US INHALA TION. I I 5 

other symptom which is more disabling, consisting in 
a palsy of the muscles, usually beginning with those 
which enable a person to open his fingers and throw 
the hand back, so that subjects of this palsy go about 
with their wrists drooping like those of a kangaroo 
or a begging dog. In fact, it is popularly called 
"wrist-drop." 

But there are a great many other substances which 
produce poisonous or other deleterious emanations. 

There are the irritating vapor's of ammonia, chlo- 
rine, and several acids — sulphurous, hyponitric, nitric, 
hydrochloric, and hydrofluoric acids. 

Etching produces fumes of hyponitric acid when 
done upon metal, and of hydrofluoric acid when done 
upon glass. Both acids are corrosive ; the latter is 
excessively so, and affects the eyes, the air-passages, 
and the hands. 

Bleaching produces fumes of chlorine gas, which is 
not injurious in small amounts ; nor is the sulphur- 
ous vapor from straw-hat bleaching of much con- 
sequence. 

The manufacture of various chemicals is injurious 
to workmen. 

Those who make sulphate of quinia are liable to 
an eruption which resembles eczema, not compro- 
mising life or health, but in some cases preventing 
workmen from continuing at the trade. 

The manufacture of potassium bichromate disen- 



Il6 SCHOOL AND INDUSTRIAL HYGIENE. 

gages caustic vapors, which destroy the mucous mem- 
brane of the nose and produce rapid-eating ulcers 
of the skin. 

One of the most terrible of diseases is produced by 
inhaling the fumes of phosphorus in the process of 
making matches — a necrosis or death of portions of 
the upper and lower jaw-bones. A surgical operation 
is required for the removal of such dead bone. It is, 
fortunately, often successful, at least as to life ; but 
an infinitely better method is the preventive one. 

In addition to this, the fumes of phosphorus pro- 
duce catarrhs of the lungs and stomach in almost all 
the workmen ; they lose appetite and become pale, 
and weak, and thin. There are several precautions 
which should be observed, but the chief one is the 
substitution of a kind of phosphorus — the amorphous 
— which is not poisonous when swallowed, and does 
not give off vapors, as common phosphorus does, at 
the ordinary temperature of the air. 

Women suffer more than men from several of the 
poisons we have named. They not only lose their 
health more readily, from a greater susceptibility to 
morbid influences of certain kinds, but their sexual 
system is very liable to be injured. "They are much 
more susceptible than men to the influence of mercu- 
rial vapors, and those who are poisoned abort fre- 
quently, and even the children that are born to them 
are apt to be weak, sickly things, and die early." 



INJURIOUS INHALATION. W] 

The infants of female operatives in certain branches 
of china-making are almost all scrofulous, with an 
enormous mortality. Lead affects women more read- 
ily and more seriously than men. They suffer from 
excessive flowing at the monthly period, and have 
frequent abortions. With regard to workers in to- 
bacco, it is stated by Tracy, of New York, that they 
have very small families; quite the reverse of what is 
usually the case with working-people. He found 
only four hundred and sixty-five children in three 
hundred and twenty-five families. It is not certain 
what the cause of this peculiar condition may be; but 
it is quite probably due in large measure to a prema- 
ture commencement of work, and to an influence 
which tobacco has in checking the sexual develop- 
ment of young girls. 

Tobacco is such an interesting subject that it is 
hard to avoid saying more. It will be safest, how- 
ever, to say but little, for we know that the whole 
subject of tobacco is to some extent an open one. It 
is hard to prove that the drug is injurious to health in 
the case of most adult persons who chew or smoke 
it, or of most operatives ; but there are some who are 
seriously, if not permanently, injured by it ; and it is 
certainly desirable to keep young persons under six- 
teen from its use. 

The chief practical points, in the prevention of dis- 
ease arising from dust, whether poisonous or not, are : 



Il8 SCHOOL AND INDUSTRIAL HYGIENE. 

1. Removal of dust by ventilators, mechanical fans, 
etc. This is enjoined by the English law of 1878. 

2. Wet-grinding, grinding in close vessels, etc., is 
sometimes practicable. 

3. The wearing of masks over the face, composed 
of wire-gauze, wire frames covered with tarletan, res- 
pirators of carded cotton, etc. ; but these are hot and 
irksome. 

4. If working with poisonous substances, the work- 
men should wash the exposed parts — face, hands, 
hair, beard — on leaving work, especially before eat- 
ing, and should never eat in the work-room. After 
work, they should change their outer clothes, and a 
daily bath is very desirable in some occupations. To 
protect from lead and other dusty poisons, a linen 
suit, frequently washed, may be worn. 

The effects of certain poisons on the female sex and 
on children are so injurious that special laws are re- 
quired to restrict their employment in manufactures 
where poisons are used. The restrictions of the Eng- 
lish Factory Act of 1878 are as follows: 

No woman, or person under sixteen, shall take 
meals in any part of glass-works in which the mate- 
rials are mixed, or where flint-glass is made, or where 
grinding, polishing, or cutting is carried on ; or in 
any part of lucifer-match works in which any manu- 
facturing process or handicraft (except that of cutting 
the wood) is usually carried on ; or in the dippers' 



INJUR 10 US INHALA TION. I 1 9 

room, dippers' drying-room, or china scouring-room, 
in any earthenware works. 

There is absolute exclusion from labor in the fol- 
lowing cases : girls under sixteen, not allowed to be 
employed in an establishment where bricks or tiles 
(not ornamental tiles) are made or finished, or salt is 
made or finished. No child under fourteen to be em- 
ployed in a part of the building where dry-grinding 
in the metal trade, or the dipping of lucifer-matches, 
is carried on ; under eleven years, all metal grinding 
is forbidden, and fustian cutting. Persons under six- 
teen are forbidden to work at silvering mirrors by the 
mercurial process, or at making white-lead. Children 
under fourteen and girls under fifteen are excluded 
from parts where the process of melting or annealing 
glass is carried on. 



CHAPTER II. 

INJURIES FROM ATMOSPHERIC CHANGES. 

THE unquestionable benefit which free exposure to 
the air in all weathers confers is subject to cer- 
tain drawbacks. It is not necessary to consider sun- 
stroke, in the case of day-laborers, nor accidents by 
falling from roofs, or from railroad collisions, as 
forming an element in "industrial hygiene;" but 
there are certain causes which affect the health per- 
manently, as bronchitis and pneumonia ; and to this 
may be added a liability to paralysis of the facial 
nerve, which is especially the possession of drivers of 
carts, etc. 

Bronchitis and rheumatism are common enough 
also among those whose trade exposes them to great 
heat, as blacksmiths, stokers on steamships, forge- 
men, puddlers, glass-blowers, dyers, and washer- 
women. It is, in fact, neither heat nor cold that 
causes the trouble, but excessively rapid transitions 
from heat to cold. 

The trade of baker is apt to be very unhealthy, 
owing to the confined, close, dark, overheated quar- 



ATMOSPHERIC CHANGES. 121 

ters in which it is carried on; also the night-work, 
and occasional excess of work. 

There is a peculiar and interesting class of disease 
which attacks those who work in diving-bells or cais- 
sons. It is caused by the excess of atmospheric press- 
ure which exists under water, which may equal several 
times that to which men are exposed on land. The 
symptoms do not, however, attack the laborer on going 
down, but rather on leaving work. The case, in fact, 
is parallel to that of the aeronaut when he rises in 
his balloon, or the climber of mountain peaks. The 
symptoms, dependent upon the removal of pressure, 
are as follows : Extreme pain ; sometimes nausea and 
vomiting; sometimes paralysis ; sometimes headache 
and dizziness. They are frequently associated with 
a sudden rush of blood to the brain and spinal cord. 
The precautions to be observed are quite interesting. 
It is recommended that only wiry men be selected for 
the work ; that their time of labor be shortened in 
proportion to the pressure ; that they take all possi- 
ble care of themselves, never going to work on an 
empty stomach, eating meat and drinking coffee, and, 
when coming out of the caisson, taking time to do it 
gradually, passing into an intermediate atmosphere 
first, and resting an hour afterwards. 

Miners. — The health of a miner is exposed to 
special causes of injury. In addition to the danger 
of being blown up, or knocked down by falling 



122 SCHOOL AND INDUSTRIAL HYGIENE. 

stones, he is constantly at work in the presence of 
great masses of minerals which generate noxious 
gases, — not to mention the effluvia which arise from 
his own person, the flame of his candle, and the burn- 
ing of powder. To this is added, in many cases, an 
excessive heat, often a steaming, sultry heat, or else 
a continual cloud of dust proceeding from the coal or 
rock under the blows of his pick. And if we further 
consider the confined position in which he often 
works, the excessive exertion, the exposure to draught, 
and the total deprivation of sunlight, we shall be 
ready to admit that his life is an unnatural one, and 
full of singular risk. 

But man can adapt himself to almost anything. 
With proper precautions, it is said that the life of a 
miner is almost as safe, and his health quite as good, 
as those of other classes in general ; better, in fact, 
than those of his own family. If this be so, it is 
certainly a great triumph of the hygienic art. 

The precautions to be taken relate first and fore- 
most to ventilation. 

" Fire-damp" is a name given to light carburetted 
hydrogen, which is given off abundantly in the car- 
boniferous strata and in enormous quantities from the 
Pennsylvania gas-wells. In the English coal-mines 
it is much more abundant than it is at present with 
us. When mixed with seven or eight times its own 
volume of common air, it is highly explosive. After 



ATMOSPHERIC CHANGES. I 23 

an explosion, the passages are filled with the irrespira- 
ble mixture of nitrogen, carbonic acid, and the vapor 
of water, resulting from its combustion. 

"Choke-damp," or "black-damp," is a name for 
carbonic acid, a common product of most combus- 
tions, and of respiration. It abounds in badly-ven- 
tilated mines. Nitrogen is not a poison, by itself. 
Carbonic oxide, however, is one of the most danger- 
ous of poisons, and so is sulphuretted hydrogen when 
present in any considerable quantity. Both the latter 
are called "white-damp." 

The heated flue, as a means of exhausting air from 
mines, has obvious dangers in coal-mines; and its 
special disadvantage lies in the variations which dif- 
ferent atmospheric conditions produce in its working. 

The steam-fan, driven by a small engine, may be 
used either for drawing air from the mouth of a mine 
or for forcing it in through tubes to the places where 
it is most needed. It is, altogether, the best means 
of ventilating mines. 

Another reason for supplying abundance of fresh 
air to mines is furnished by the great heat which is 
found under ground. In the Cornish mines, the tem- 
perature is said to increase regularly about one degree 
Fahrenheit in every fifty feet in the upper parts, and 
one in every eighty-five feet in the lower parts ; and 
this is, with local exceptions, nearly the rate at which 
the temperature rises in other mines. Some of the 



124 SCHOOL AND INDUSTRIAL HYGIENE. 

exceptions, however, are very remarkable. The deep 
levels of the mines on the Comstock Lode in Nevada 
have temperatures varying from 105° to 130° Fah. ; 
and this excessive heat is mitigated by blowing upon 
the men fresh air at 90 or 95 , which seems to be 
most conducive to comfort. The men, under these 
circumstances, work with great vigor, but have to be 
frequently relieved. 

This great heat is said to be very productive of 
heart-disease. There is no doubt that this effect is 
intensified by excessive barometric pressure and by 
dampness of the air, preventing evaporation from the 
body. It is affirmed that the system in use at the 
Comstock is so thorough as to do away with most of 
the danger from all of these sources. 

To spare the men a needless and wasteful expen- 
diture of bodily force, it has been found best to use 
cages worked by engines to raise and lower those who 
are going to or from work. 

The excessive quantity of coal-dust which chokes 
the air of badly- ventilated mines has been previously 
alluded to as affecting the lungs. But there are other 
causes of pulmonary trouble, quite obvious in their 
nature, such as sudden changes from heat to cold, 
and deliberately sitting down in draughts to cool off 
after working in the high temperatures mentioned. 
On the whole, the principal diseases are miners' asth- 
ma, consumption, and rheumatism, and, among those 



ATMOSPHERIC CHANGES. 125 

who have worked long in badly-ventilated places, 
dyspepsia, tremors, vertigo, and other troubles arising 
from blood-poisoning. 

As regards accidents, they are due to a great many 
various causes ; but more than one-half of them, in 
the Pennsylvania coal-mines, are caused by falls of 
rock, coal, or slate. It is the opinion of good judges 
that a very large number of these casualties could be 
avoided by sufficient timbering of the roofs and sides. 
One and a quarter in every hundred, or 12 \ men in 
every 1000 employed in these mines, are killed or 
wounded every year by accidents ; and it seems that 
here is a distinct and obvious field for a humane reform, 
either by legislation or by private effort. 

Soldiers and Sailors. — In most of the European 
services great numbers of the men used to die of con- 
sumption and allied diseases, and fevers, probably 
chiefly typhoid. This lamentable result was not in 
the least due, however, to exposure to weather, but to 
what may be called a contrary condition — the want of 
fresh air in barracks. In certain of the best English 
regiments the losses were from one-third more to twice 
as great as among men of the same age in civil life. 
The fearful loss of life from disease in the Crimea is 
well known ; and it is from that time that the reforms 
date which have brought down the total rates of death 
from disease to one-half of what they were. The 



126 SCHOOL AND INDUSTRIAL HYGIENE. 

present allowance in England is 600 cubic feet of 
space to each man in barracks. 

The ills of sailors are, to a very great extent, caused 
by want of fresh air, dirt, and dampness. It is com- 
monly forgotten that, by washing down the deck fre- 
quently, a source of disease is introduced which is at 
least as dangerous, and in feverish localities ten times 
more dangerous than simple dry dirt. Good ventila- 
tion and scrubbing and drying are the cure for the 
chief of the curable ills of ship-life. 



CHAPTER III. 

INJURIES FROM OVER-USE OF CERTAIN ORGANS. 

IT is as true of the mind as it is of the body, that no 
one part can be exclusively used without injury to 
the individual considered as a whole. In the broadest 
possible division of our being, neither "mind" nor 
"body" has a right to exclusive cultivation; and 
such exercise is never in the interest of the best phys- 
ical health. The same is true if we subdivide the 
faculties of body and mind. There are many ways 
in which the mind is exercised in daily life : book- 
study, concentration of attention on discourse, mem- 
orizing, reproducing, extemporary discourse; atten- 
tion to great single questions in business, and to mul- 
titudes of petty ones ; ciphering and copying by the 
day, and the vivid, sudden, mortal collisions of the 
street. None of these can properly be kept up to the 
exclusion of the others, unless there is a strong pre- 
disposition and fitness on the part of the individual : 
they should alternate with one another, for most per- 
sons are incapable of sustaining continued strain in one 
of these points. We say that " worry " kills a man; 

127 



128 SCHOOL AND INDUSTRIAL HYGIENE. 

but in saying so we mean simply that the mental ex- 
citement upon one subject, which is perfectly health- 
ful if continued for a few hours, becomes tyrannical 
and destructive if kept up for whole days. A man 
may be worried into illness by incessant, quiet cipher- 
ing as well as by attendance at the Brokers' Board. 

The care of the mental health has been sufficiently 
treated of in another of this series of Primers.* It 
is my purpose here briefly to mention some muscular 
affections which are caused by monotonous and ex- 
cessive work. 

The robust activity of the blacksmith and carpen- 
ter do not exempt them from the general law. They 
are liable to a disease termed "hammer-palsy," af- 
fecting the muscles which are overworked. 

A painful and very unfortunate affection sometimes 
attacks those who write a good deal. The premoni- 
tion is given sometimes by pain in the muscles em- 
ployed in holding the pen. There is apt to be a 
nervous condition of the system, a tendency to 
anxiety ; but this is not always the case. As seen in 
its typical form, the disease presents no token of its 
existence until the person affected begins to perform 
one special act, as, in the present instance, the act of 
writing. There may be great muscular vigor, and 
complete control of all the faculties and motions 

* " Brain-Work and Overwork," by H. C. Wood, M.D. 



OVER -USE OF ORGANS. \2<) 

except one ; but as soon as the patient undertakes to 
grasp the pen and write, he finds his fingers in a state 
of cramp ; they pinch the pen excessively, or they fly 
back from the pen, making it impossible to hold it. 
It is very desirable that this should be recognized in 
an early stage, as it is a malady somewhat difficult of 
cure, and absolutely disabling as respects clerical 
work. Some reader may thank me for saying that 
electricity has been applied of late with good success 
to the treatment of Writer's Cramp or Palsy. 

The affection here described is not confined, how- 
ever, to writers, but affects also pianists, violinists, 
engravers, seamstresses, telegraph-operators, tailors, 
type-setters, and many other classes who use one set 
of muscles almost exclusively. 

The theory has been put forward that writer's cramp 
is caused by an electric current generated in a metallic 
pen, or by the contact of pen and holder. This can- 
not be admitted. The disease is fundamentally the 
same, whether caused by work with the pen or on 
catgut or ivory. But a steel-pen may be found inju- 
rious, and can be replaced by gold or quill; or a 
large pen-holder may be used, made of cork, of the 
size and shape of a large cigar, which is felt by many 
to be a great comfort in writing. A departure from 
the prescribed mode of holding the pen, and placing 
it between the forefinger and the middle finger, may 
also be a relief. Dr. Frank Woodbury, of Philadel- 

I 



I30 SCHOOL AND INDUSTRIAL HYGIENE. 

phia, has lately invented an ingenious pen-holder to 
prevent writer's cramp, by regulating the pressure at 
which the pen is used by a slight spring. But if the 
disease has developed itself, no such palliation is of 
any avail ; and if the sufferer learns to write with the 
left hand, as has been done, the left hand also is liable 
to be attacked. The temporary use of the "type- 
writing machine " will often prove a great boon, per- 
mitting a continuation of work while resting the af- 
fected muscles. 

The effect of using sewing-machines is sometimes 
injurious. It is not worth while to mention any 
special effects. The muscular exertion, however, is 
of a monotonous character, and may produce mus- 
cular fatigue which is prejudicial to the general 
health. It has been known to cause neuralgia of the 
foot and leg. In general, the use of the machine two 
or three hours a day is probably beneficial to most 
women ; but a whole day's work, if the machine is 
run by the feet of the worker, is far too severe, and 
steam-power had better be used. Much has also been 
done by applying the principle of alternate effort, by 
a treadle which is moved both by the downward and 
the upward movement of the feet, and employs both 
feet at once or one at a time, at will. Many will 
find relief by alternate basting and sewing each for 
twenty to thirty minutes. 

Steam-power has been applied with success to run- 



OVER -USE OF ORGANS. I3I 

ning sewing-machines. I am told by the head of a 
large manufactory of ladies' dresses that the machines 
do one-third more work than when run by the foot; 
and that the girls will work for less wages when steam- 
power is used. 

Those who use the voice a great deal in public 
speaking and singing are apt to suffer from the strain. 
The most common affection is follicular pharyngitis, 
or "clergyman's sore-throat." Much of this trouble 
is unnecessary, strictly speaking, or could be remedied 
if the right steps could be taken. The voice ought 
not to be used for continued and difficult efforts, un- 
less the possessor is in good health and strength. It 
ought not to be used in the crude, ignorant, and even 
unintentionally "affected" manner which is often 
heard, and which fatigues the throat without need. 
The services of a competent teacher in elocution are 
to be desired, not so much for rhetorical purposes as 
for training in the right way to work with the vocal 
organs. And by way of support, a little gymnastics, 
for developing the chest, shoulders, and abdomen, 
may properly accompany the process of developing 
the voice, in some cases. 

This is a fit place for a brief mention of the inju- 
rious effects of protracted labor in one position. 
Shoemakers and tailors, owing to their constrained 
attitudes, and the bad air of their shops, become 
dyspeptic, anaemic, and consumptive, and do a great 



132 SCHOOL AND INDUSTRIAL HYGIENE. 

deal more thinking than is good for them. The 
sedentary life of literary people and clerks is apt to 
affect them similarly. 

Persons who stand all day at their work, as sales- 
people and hair-dressers, are apt to have pains in the 
soles of their feet, which may sometimes be relieved 
by a well-shaped steel-shank to the shoe. Varicose 
veins of the lower limbs, and uterine irregularities, 
are also caused by standing. It is a truly inhuman 
thing to require girls and women to remain on their 
feet all day, without regard to the presence or absence 
of customers — an inhumanity that we are glad to 
believe is diminishing. 



A 



CHAPTER IV. 

INJURIES FROM ACCIDENTS. 

VERY considerable number of accidents are 
caused every year by machinery used in manu- 
facture. In England, in 1875, 2 -6 persons in every 
1000 factory-hands were injured in this way. In the 
United States there were 420 reported deaths caused 
by machinery in 1870, and the number of injuries 
was of course very much greater. 

The English Factory Act appoints inspectors, who 
must not be interested in or connected with factories 
in any other way, and who are invested with the 
necessary powers for carrying the act into effect. 

Some of the provisions of the act are here given, 
from an abstract published in Professor William Wat- 
son's paper in the Journal of Social Science, No. XI. 

Certain portions of a mill, as hoists, fly-wheels, 
wheel-races, mill-gearing, vats, etc., are required to 
be fenced, and whenever the machinery, by reason of 
its character or situation, is, in the opinion of the 
inspector, likely to cause accidents to the work- 
people, he is to serve on the occupier a notice 
«2 • »33 



134 SCHOOL AND INDUSTRIAL HYGIENE. 

requiring him to fence the part of the machinery 
which he deems to be dangerous. The occupier 
may, by serving a requisition on the inspector within 
seven days of the receipt of the notice, refer the mat- 
ter to arbitration. 

A child (under fourteen) is not allowed to clean 
any part of the machinery of a factory while in mo- 
tion. A young person (from fourteen to eighteen) or 
woman ("over eighteen) is not allowed to clean such 
part of the machinery as is mill-gearing, while the 
same is in motion. A child, young person, or woman 
is not allowed to walk between the fixed and travers- 
ing part of any self-acting machine while the same is 
in motion. 

Accidents causing death, or disabling the person 
more than forty-eight hours, must be reported to the 
inspector and visiting surgeon by the occupier of the 
factory or workshop. The surgeon is to examine at 
once the nature and cause of the accident, and report 
to the inspector within twenty-four hours. 

Neglect to keep a factory or workshop in conformity 
with the act is punishable by a fine' not exceeding 
_j£io ; and the court (of summary jurisdiction) may 
inflict a fine, not exceeding ^100, for the benefit of 
the injured person or his family, or otherwise, in case 
of death or injury in consequence of neglect to fence 
machinery as required. 

Professor Watson, in the same paper, gives a very 



INJURIES FROM ACCIDENTS. 1 35 

interesting account of an Association for the Preven- 
tion of Factory Accidents, existing at Mulhouse, in 
Alsace. It consists of twenty-four members, com- 
prising mill-owners, superintendents, manufacturing 
engineers, foremen, and workmen chosen by the In- 
dustrial Society of the city, with the aid of the work- 
men. The Association offers arbitration, in cases of 
claims for damage, and uses various means for spread- 
ing a knowledge of the dangers and their remedies. 
At the Paris Exposition of 1878, they exhibited twen- 
ty-seven examples of contrivances adapted to prevent 
very severe accidents such as commonly occur, 
especially from belts, shafts, pulleys, wheels, and 
circular-saws. It would be well if our employers of 
labor in large manufacturing centres, such as Phila- 
delphia, Fall River, Lowell, etc., would imitate this 
humane example. 

Railway accidents may be properly mentioned in 
this place, for they affect the employes in vastly 
greater proportion than the passengers. For instance, 
in France, from 1854 to 1869, the number of travellers 
killed and wounded on railroads was 2,832; but that 
of employes was 11,908. If we consider how few 
men are required to run a train carrying hundreds of 
passengers, we cannot help being struck with the 
great disproportion. 



CHAPTER V. 

REGULATION OF HOURS OF LABOR. 

THE application of machinery and steam-power to 
the manufacturing arts has made England the 
richest country in the world. But this wealth was 
attained, at first, at a cost of human suffering and 
death which makes a sad page in history ; a page 
which, fortunately, has not been paralleled in our 
country. No system of labor has existed here, upon 
a large scale, by which a boy of eight years could be 
carried daily to work for sixteen hours in a mill, with 
half an hour for meals. We have not seen large 
numbers of little children beginning a full day's 
work at six years of age ; nor have we frequently 
seen the consequent distortions and deformities 
known in England as the "factory-leg," due to 
standing an excessive length of time. No large 
numbers of women here work all day, leaving little 
infants in the charge of baby-farmers. 

It is useless to expect that these things will always 
go right of themselves. The absence of legislation 
on hours of labor, for the protection of women and 

136 



REGULATION OF HOURS OF LABOR. 1 37 

children especially, is excusable in some of our States, 
on the ground of the subordinate nature of the in- 
dustry. But the want of uniformity which is seen in 
the laws of States which have attempted statutory 
regulation is a little startling, and obliges us to infer 
that American views are not so definite on some prac- 
tical points as they might be. 

From a communication sent me by Dr. Roger S. 
Tracy, of the New York Board of Health, I compile 
the following statements, which will give a nearly 
complete idea of what has been done hitherto. Dr. 
Tracy examined the statistics of the twenty-eight 
principal States, and found the following: — 

Factories. — Labor forbidden to children under 10 
in Massachusetts and New Jersey; under 12 in Rhode 
Island and Wisconsin ; under 13 in Pennsylvania. 

Coal-mines. — Labor forbidden to children under 
12 in Pennsylvania; to children under 12 and all 
women in Illinois, and under 14 in Colorado. 

Factories. — Over ten hours' work daily forbidden 
to children under 14 in Michigan ; 15, in Connecti- 
cut; 16, in Maine and Maryland; 18, and all women, 
in Ohio. 

Factories. — Over eight hours' daily work forbid- 
den to all under 18, and to all women, in Wisconsin. 

Educational, requirements are made in eight of the 
twenty-eight States. The strictest are those of Wis- 



I38 SCHOOL AND INDUSTRIAL HYGIENE. 

consin, where children are not to be employed while 
the public schools are in session. 

This is about all that has been done in our country 
for the protection of women and children from ex- 
cessive and improper labor. There are laws relating 
to the employment of children in fourteen of the 
twenty-eight States ; but a large number of the laws 
relate to educational and not to sanitary points. 

It is certainly a singular discrepancy that, in Mas- 
sachusetts, parents are allowed to send a child of ten 
years old to work ten hours in a factory, while in 
Wisconsin only eight hours of labor are allowed at 
the age of twelve to eighteen. 

The English legislation has been thorough and en- 
lightened, showing upon the part of its authors a 
degree of humanity, painstaking, and intelligence 
which go far to atone for previous sins of neglect. 
Its provisions are as follows: — 

Children under 10 shall not be employed in any 
factory or workshop. 

A medical certificate is required, in the case of all 
persons under 16, of the fitness of such persons for 
employment in the factory specified. The employer 
procures this certificate, and is responsible for proving 
the age. The Government Inspector may require a 
certificate, if a person under 16 seems to him unfit, 
and may forbid his working again until recertified 
by the certifying surgeon. The examination is made 



REGULATION OF HOURS OF LABOR. I 39 

at the factory. Refusal to give a certificate must be 
accompanied by written reasons. 

Persons under 14 shall not be employed on Sunday 
in workshops or factories. Christmas, Good Friday, 
and eight half-holidays besides, are given. 

Children are employed (under 14) under one of 
two plans : — (a) in alternate sets, morning and after- 
noon; (J>) on alternate days. The morning work ends 
at 1, or at dinner if earlier. The afternoon work 
begins at 1, or after dinner if later. The day is 12 
hours long, viz. : from 6 to 6, or 7 to 7, for children, 
voung persons, and women, with ij hours for meals. 
On Saturday the day ends at 2 o'clock. 

Children must not be employed more than five 
hours continuously without a meal (half-hour). All 
must eat at the same hour (children, young persons 
under 18, and women), and never where work is 
going on. 

Every child under 14 in a factory or workshop 
must attend a school, either on the alternate off-days 
or on the half-days when off work. If he fails to 
attend in any week, he shall not recommence work 
the next week until he has made up his absence from 
school. The employer obtains certificate of attend- 
ance. 

The parent selects the school. Proficiency in the 
elementary studies, which satisfies a certain standard 



I40 SCHOOL AND INDUSTRIAL HYGIENE. 

fixed by Government, enables a child at 13 to work 
as if over 14, — as a "young person." 

The school is authorized to collect its fees from the 
occupier of the factory, to a certain extent, the 
amount to be deducted from the child's wages. 

It is not in my power to say whether the health of 
the rising generation is suffering from overwork or 
confinement in factories in our States. There is not 
much evidence to prove it. The investigation pub- 
lished in the Massachusetts State Board of Health 
Report for 1871 is not at all alarming in its results. 
It found that " the correspondence in death-rates be- 
tween the factory population and the whole popula- 
tion, at the same ages, was so remarkably close as to 
leave but little to be said " (page 422). 

There is in modern labor a tendency to aggregate 
persons and resources in great masses, which pro- 
duces town-life, large enterprises, and great factories. 
In many ways this is to-be deplored; but it is right 
to see the bright side also. The old system of inde- 
pendent workshops, where the weaver or other me- 
chanical toiler spent all the time he could possibly 
give in small, crowded shops, often in his own room, 
in narrow and nasty quarters at the best, has given 
way to the system of large shops, which are run for a 
much smaller number of hours, are far better lighted 
and warmed and aired, and, what is perhaps the root 
of the whole matter, are much more accessible to the 



REGULATION OF HOURS OF LABOR. I4I 

control of public opinion and to legislative inspec- 
tion. It is in the large shops that you find the large 
brains at the counting-desk — men who can under- 
stand sanitary needs, and are not hampered by the 
petty necessity of domestic economy which weighs 
down the solitary workman. It is the large establish- 
ments that take the trouble to answer questions upon 
sanitary matters addressed to them by the State au- 
thorities. 



CHAPTER VI. 

DURATION OF LIFE IN VARIOUS OCCUPATIONS. 

AS everybody would like to know that he has a 
prospect of long life, everybody has a certain 
curiosity in regard to the statements of science con- 
cerning the effect of his own work on the duration 
of life. There are a good many facts going the 
rounds, and if taken with allowances for the circum- 
stances, these facts are valuable. But there is so 
great a contradiction between the statements of dif- 
ferent authors, that the most meagre statements are, 
perhaps, the safest. 

From Hirt's tables I select a typical trade or two to 
represent each period of life, dividing life into periods 
of five years. My selection is, of course, arbitrary. 

Among the operatives who die on the average be- 
fore the age of 40 years, I find porcelain-turners, 
stone-cutters, and female mirror-makers. 

Under 45, goldsmiths, lead and quicksilver miners. 

Under 50, cabinet-makers and operatives in cotton- 
mills — not very wholesome, and not particularly 
hurtful occupations. 

Under 55, to my surprise, come some trades which 
I should have put much lower. Needle-polishers are 

142 



DURATION OF LIFE. 1 43 

said to average 50, file-cutters 54, engravers 54.6, 
and so forth. It is possible that a good many classes 
fall in here simply because it is rather a medium age 
at which to die, independently of other circumstances. 

Under 60 years (also a good medium age, on the 
favorable side,) we find blacksmiths, butchers and car- 
penters, machinists and turners, the watchmaker who 
measures our life for us, and the grave-digger who 
takes our measure for the last time. 

Under 65, it is interesting to find set down the 
classes of tanners, dyers, gas-men, catgut makers, and 
bone-boilers — trades which may remind us that long 
life is not to be attained by shirking disagreeable or 
offensive tasks. 

Above 65, only three trades are mentioned. 

In England, the rates of mortality among different 
classes have been estimated by Dr. Farr, who states 
that the shortest lives are found among earthenware- 
makers, tailors, needle-makers, makers of files and 
saws, veterinary surgeons and farriers, railway em- 
ployes, coachmen and cabmen, commercial clerks, 
butchers, publicans, innkeepers. A good deal of this 
mortality is due to habits of excessive drinking and 
exposure to the weather. 

Physicians and surgeons, chemists and druggists, 
mercers and drapers, hair-dressers, barbers, wig-mak- 
ers, and hatters, miners, and some others, have a high, 
but not an excessively high, rate of mortality. Carv- 
ers and gilders suffer less than they did ; and manu- 



144 SCHOOL AND INDUSTRIAL HYGIENE. 

facturers of wool, silk, and cotton no longer experience 
an exceptionally high mortality, owing to the zealous 
efforts made by Lord Shaftesbury and his enlightened 
colleagues in promoting sanitary legislation. 

Among the healthy classes may be named carpen- 
ters, wheelwrights, and workers in wood generally ; 
shoemakers, grocers, publishers, and booksellers. 

Among the healthiest and longest-lived are the 
agricultural classes, game-keepers, barristers, and the 
clerical profession. But solicitors and Catholic priests 
in middle and later life form exceptions. 

Metal workers, in the aggregate, do not experience 
the average rate of mortality under 45, but after this 
age the case is reversed ; miners have a still higher 
rate, and both classes have a much higher rate than 
agricultural laborers. 

From the " Massachusetts Registration Reports" I 
will quote the following statement of the average age 
at death of nine general classes of men, the average 
of all classes and occupations being 50.94 years : 

Average Age at Death. 



I. 


Cultivators of the earth . 


65-«3 


II. 


Active mechanics abroad 


52.62 


III. 


Professional men 


50.81 


IV. 


Merchants, financiers, agents, etc. 


49.22 


V. 


Active mechanics in shops 


47.92 


VI. 


Laborers, no special trades 


47-24 


VII. 


Employed on the ocean . 


46.09 


VIII. 


Inactive mechanics in shops 


43-64 


IX. 


Factors laboring abroad . 


35-42 



NOTE. 



The following works on gymnastics may be named 
as useful : 

Manual of Gymnastic Exercises, arranged on Hygienic Prin- 
ciples and adapted to music. By E. H. Barlow. Amherst, 
Mass., 1866. 

Manual of Gymnastic Exercises for Schools and Families. By 
Samuel W. Mason. Boston, 1863. 

Handbook of the Movement Cure for Prevention of Spinal 
Deformities. By M. Roth. 

How to Get Strong, and How to Keep so. By William 
Blaikie. 

Training in Theory and Practice. By Archibald Maclaren. 
13 K '45 



INDEX. 



PAGE 

Aoortion caused by mercurial 

poisoning 116 

from lead poisoning 117 

Accidents I33 -I 35 

legislation to prevent. 133, 134 

precautions 134, 135 

on railways 135 

in mines 125 

Adams's statistics of distorted 

spines 37 

Afternoon schools 61,62 

study 21 

Age, as determining capacity for 

study 31, 32 

Air, quality of supply for turnace 86 

overheated 86, 87 

from cellars 91 

See Ventilation. 

American desks and seats for 

schools 67 

factory and mining legisla- 
tion 137 

Amherst College gymnastics 44 

statistics of near-sight 58 

Anxiety injurious to health 14 

Apparatus for gymnastics 36 

Appetite, failure of, sign of over- 
study 19 

Application, capacity for contin- 
uous mental, at different ages.. 30 

See Study. 

Architectural ornament subordi- 
nate to hygienic requisites 84 

Arsenic in wall-paper 111, 112 

chronic poisoning, symp- 
toms 112 

in kindergarten paper 112 

in stockings 113 

in artificial flowers 113 

— — in certain ores 114 

Astigmatism mistaken for short- 
sight 55 



PAGE 

Atmospheric changes, injury 
from 120-126, 143 

Attention, power of, at different 
ages 30 



Back, support for 68, 78 

Bakers 120 

Base-ball, when injurious 38 

Bigelow, H. J., on chairs 68 

Blackboards, position 83 

Black-damp 123 

Bleaching 115 

Boarding-schools, some good ef- 
fects on health 23 

See pages 98-101. 

for girls 100 

Boards of Health, duty in conta- 
gious diseases in schools 100 

Bodily development, when com- 
plete 35 

growth 24-27 

Book-rest 70 

Bowling, when injurious 39 

Boys, rate of growth 24 

Brain, constant repair of 28 

Breakfast neglected by children.. 17 

study before 20 

Bronchitis 120 

Brooklyn, statistics of near-sight 58 
Brown, Buckminster, injury 

caused by military drill 46 

on origin of spinal de- 
formity 64 

Buffalo, statistics of near-sight... 58 



Caisson disease 121 

Calisthenics 36 

specimen of 46 

Carbonic oxide from furnace 87 

Carter, Brudcnell, on care of eyes 48 



I46 



INDEX. 



147 



, I40 



117 



58 



PAGE 

Carter, Brudenell, on near-sight. 60 

Catarrhs 93 

Cellar air 91 

water-closets in 96 

Chadwick, Edwin, on hours of 

study „ 29-31 

Chair-back, main use 68 

Children, mental characteristics 

7.. 2 9. 3°. 3i 

requirements in exercise 35 

bodily peculiarities 61 

sickliness owing to mothers' 

trade 116, 117 

legal restrictions on labor... 

119,134-137 

See Ages. 

China-makers, scrofulous chil- 
dren 

Choke-damp 123 

Cincinnati, statistics of near- 
sight 

City life, injurious to health of 

children 27 

Clarke, E. H., on sex in educa- 
tion 26 

Clergyman's sore throat 131 

Closets for scholars' clothing 84 

"Clothing 40, 44, 47, 93 

Coal-dust inhaled no 

Conn's statistics of near-sight 57 

Colleges 102-104 

■ for girls 100 

study in 32 

Color of walls 83 

Commons at college 104 

Competition between girls and 

boys 25 

Comstock lode 124 

Congestion as a cause of near- 
sight.. 53 

Conjunctivitis 63 

Conklin, effect of school-life on 

eyesight 59 

Consumption caused by inhaling 

dust 107-110 

among miners 124 

soldiers 125 

Contagious diseases 105, 106 

of eyes 63 

Coralline "3 

Cotton-mills, dust no 

Croquet, how injurious 39 

Cubic space required in school- 
room 89 



(AGE 

Cubic space for dormitories 99 

■ in barracks 126 

Culture, its true scope __ 10 

Curvature. See Spinal. 

Dampers of furnace 86 

Danneberg on gymnastics, at 

Frankfort 43 

Dayton, Ohio, statistics of near- 
sight 58 

Deafness often misunderstood by 

teachers 49 

Decoration of school-room 83 

Deformities from factory-work... 136 

See Spinal. 

Derby, Hasket, statistics of near- 
sight 58 

Desks, faulty construction.... 65, 66 

height of. 74 

assorted sizes 74 

Development. See Growth. 

Diet of school-children 17 

See Food, Commons. 

Dinner, time for 21 

Discomfort as a cause of deform- 
ity 66 

Discontent, effect on health 14 

Disinfection 105 

Distance for reading, etc. 49, 53, 54 

Diving-bells 121 

Dormitories in schools 99 

■ — — in colleges 104 

Drawing 57 

bad position in 64 

Dress for gymnastics 40, 44 

See Clothing. 

Drill of scholars 95 

Drudgery of schools 15 

Drunkenness, mortality from 143 

Duration of continued mental ap- 
plication 31 

of life in various occupa- 
tions 142-144 

Dust, poisonous 111-119 

prevention of 109, no, 117, 118 

Duty, unregulated sense of..... 8, 11 
training of sense of. 9 

Earthenware makers no, 143 

Education, principles and theo- 
ries of; 7, 13 

claims the whole child 8, 10 



148 



INDEX. 



PAGE 

Education should include morals 

and health 9, 10 

should develop power, en- 
durance, self-control n 

should develop spontaneity 29 

See Study. 

Educational legislation i37 - *39 

See Half-time. 

Elbows on desk 70 

Embroidery 57 

Emotional strain upon pupils .... 14 

Emulation, its power 8 

injury from 8 

methods of arousing it 16 

Enamellers 114 

England, half-time system 32 

diseaseamongfactory-hands 136 

English Factory Act of 1878 

118, 119, 133, 138-140 

Engravers 129 

Equilibrium of mental powers, 

when disturbed 14 

Erismann on size of school-room.. 79 

Etching 115 

Eulenberg's statistics of distort- 
ed spines 37 

Evaporation of water 87 

Examinations of schools 17 

Excess of study defined 28 

Exercise, physical 34~47 

adapted to different temper- 
aments 34 

by walking 34, 35 

byplay 38 

J- J- Putnam on 38 

by military drill 46 

See Walking, Gymnastics, etc. 

Exhibitions of schools 16, 17 

Explosion of gas 122 

Eyes of young children allowed 

to wander 61 

care of. 48-63 

ignorance of teachers about 48 

Brudenell Carter on care of. 48 

near-sighted 48, et seg. 

distance from book... 49, 53, 54 

effect of general weakness 

of disease upon 52 

See Near-sight, Weakness, 

Far-sight. 

Factories, English 136 

— — American.; 137 



PAGE 

Factories, health of operatives... 140 

Farr on life statistics 143 

Far-sight 62 

simulating near-sight 51, 55 

Fatigue not the prime object of 

exercise 34 

Fevers, prevention of spread 105 

Field-sports, 34 

File-cutters no, 143 

Fire-damp 122 

Fire on the hearth, principles of 88 
Fireplace, aid to ventilation.. 88, 98 

See Open Fire. 

Floor of school-room 84 

Follicular pharyngitis 131 

Food 19, 23 

trashy 22 

suitable 23 

deficient supply 22 

See Commons, Meals. 

Frankfort, public school gymnas- 
tics 41-4 ( 

Furnace, supply of air to 86 

valves 86 

should be large 86 

dampers 86 

producing carbonic acid 87 

water for 87 

Furniture for schools. See Desks 
and Seats. 

Gas-light, ventilation of. 87 

Gas. See Explosion. 

German school-seats 67.68 

Gilders 114 

Girls, rate of growth 24 

— — competition with boys 25 

about age of 14 and 15, spe- 
cial care of. 25, 26 

injured by " society" 26 

choice of gymnastics for 43 

should not have to climb 

many stairs 95 

Glasses should be worn by some 

children 60, 63 

to be selected by physicians 

only 63 

when to be worn by children 69 

Glass-makers no, 114 

Grinders' asthma 108 

Grinding, wet and dry 109 

glass n 4 

■ colors , 114 



INDEX. 



149 



PAGE 

Ground glass 83 

Growth of body 24, 27, 35 

Gymnastics, Ling's system of..... 41 

for girls 43 

in Amherst College 44 

in normal schools 44 

in colleges 102, 104 

precautions in 103 

teacher for 103 

for boating-men 103 

Habits of health taught i n 

school 9 

Hair-dressers 132 

Half-time system of education 

in England 32, 62, 139 

Hammer-palsy 128 

Harlan, diagram to illustrate 

near-sight 50 

Hatters 113 

Health, laws of, taught in 

schools 9 

Heart-disease in miners 124 

Heat of mines 123 

Heating. See Ventilation. 

High-schools, study in 32 

Hirt's life-statistics 142 

Holidays in factories 139 

Horseback exercise sometimes 

injurious 39 

Immorality in schools 99 

Inhalation of dusty and poison- 
ous substances 107, 119 

Ink, pale, bad for eyes 57 

Inspection of schools by medical 

authority 45, 106 

Irksome tasks 15 

Janitor's duties 91 

Juvenile labor on half-time sys- 
tem , 3 2 

Keen, W, W., ventilation 92 

Kindergartens 29, 35 

green papers 112 

Konigsberg, statistics of near- 
sight 58 



n' 



PACE 

Lead-poisoning 114, 115 

Lead, effects on women 117 

Legislation. See English Fac- 
tory Act, Restricti ons, Women, 
Children, Education. 

Length of life 142 

Liebreich, construction of desks 

and seats 67, 77 

on spinal curvature 74 

Life, duration of. 142, 144 

Light, defective, causes stooping 69 
horizontal useless in read- 
ing 81 

what constitutes good 82 

dazzling eyes at work 83 

direct rays of sun 83 

artificial 83 

in private house .- 98 

See Windows, Shades. 

Ling's system of gymnastics 41 

Long-sight. See Far-sight. 
Lonng. E. G., and R. H. Derby, 

statistics of near-sight 58 

Lot, size of, for school 94, 95 

Lunch for children in school 22 

Lungs affected by inhaling dust, 

107, no 

Maine ventilation 92 

Maps 56, 57 

Masks to protect from dust 118 

Massachusetts Registration Re- 
port on average age at death.. 144 

State Board of Health on 

prevention of spread of conta- 
gion in schools 106 

State Board of Health on 

health of operatives 140 

Matches 116 

Meals, interval between study 

and 20 

intervals between 21 

sleepiness after 21, 22 

in factories 139 

Medical inspection of schools, 

45. *°6 
Mental application, excess de- 
fined . 28 

characteristics of children... 7 

depression a symptom of 

over-study 15 

See Study. 

Mercury, effect on hatters 113 

— ■ -. — r mirror-makers 113 



ISO 



INDEX. 



PAGE 

Mercury, effect of on gilders 114 

symptoms of chronic poison- 
ing 114 

effect on women 116 

Military drill in schools 46 

Miners 121, 125, 143 

Mirror-makers 113 

Morality taught in schools 8, 9 

Mulhouse, Association for the 
Prevention of Factory Acci- 
dents 135 

Muscles, affections caused by 

over-work 128 

Music, practice 101 

Myopia. See Near-sight. 

Near-sight defined 49 

tends to increase 49 

diagram 50 

prevention of increase... 50, 52 

things mistaken for it.... 51, 54 

causes of. 51, 53 

inheritance of. 51 

pathology of 51 

favored by weakliness 52 

bad air 52 

is not strong-sight 53 

dangerous tendency of. 53 

Harlan on 54 

caused by fine work, etc 57 

— — statistics 57, 59 

"increasing 59 

effect on character 60 

what is lost by it 60 

should be corrected by 

glasses in children 60 

as related to compulsory 

education 59, 60 

related to spinal curvature- 74 

Necrosis from phosphorus 116 

Nervous systeminjuredinschools 

14, 18, 100 
Neufchatel, statistics of distorted 

spine 37 

Neuralgia from use of sewing- 
machine 130 

New York, statistics of near- 
sight 58 

Nitrogen in mines 123 

Ophthalmia 63 

Over-study, signs of. 16, 19 



PAGE 

Over-study described 17 

defined 28 

Over-use of organs 127-13? 

Painters 114 

Paper, tint of 56 

Paris Exposition of 1878, con- 
trivances to prevent accidents. 135 

Phosphorus 116 

Pianists 129 

Piano, bad position at 64 

Play, city children deprived of.. 

27» 38, 39 

advantages of. 38 

when injurious 38, 39 

when inferior to gymnastics 39 

recommended 101 

Play-grounds 43, 94 

Pneumonia 109 

Poisons and dust, effect of in- 
haling 107-119 

Porcelain-makers no 

Position in reading 55 

sitting 67-69 

faulty in writing, etc., as re- 
lated to spinal curvature 64, 73, 74 

in writing 68, 70 

should be frequently varied. 70 

Potassium bichromate 115 

Primary schools 32 

Principles of education 7-13 

Print, bad 56 

Printers 114 

Private schools 98-101 

Prizes to school-children 16 

Professions, duration of life in 142-144 
Putnam, J. J., on gymnastics 38, 40 

Radiation 87 

Recesses in school 47, 62 

Reading, position in 55 

while sleepy 56 

Regulation of hours of labor 136-141 
Religion not taught by the State 8 
Repair of brain and other organs 28 

Rest of eyes during study 54 

Restrictions on labor of women 

and children 118, 119, 134, 137, 139 
Rheumatism 109, 120, 124 

Sabbath 35 



INDEX. 



151 



PAGE 

Sailors 126 

Sales-people 132 

Scheeie's green 113 

School-house, site 94, 95 

height 95 

School-room, a model 79-84 

shape, dimensions 79, 80 

Schweinfurt green 113 

Seamstresses 129 

Seats and desks 64-78 

faulty construction 65,66 

principles of construction 66-78 

Liebreich's 67, 77 

German 67 

table of dimensions 76 

Varrentrapp's model 75 

should not be ranged in semi- 
circle 82 

Sedentary life 131, 132 

Sewerage of schools 96 

Sewing-machines 130 

Sex in education 26 

Shades to windows 82 

Shaftesbury, Lord, legislation.... 144 

Shoemakers 131 

Short-sight. See Near-sight. 

Singers 131 

Slates 57 

Sleep, loss of, a sign of over- 
study 16, 19 

Sleepiness after meals 21, 22 

should forbid reading 56 

"Slow sight" 55 

Society, injurious effect on school 

girls 26 

Soldiers 125 

Speakers 131 

Spectacles. See Glasses. 

Spinal distortion in girls 36, 38 

at Neufchatel, etc 37 

• prevented by gymnastics.... 38 

Buckminster Brown on ori- 
gin of. 64 

related to bad position in 

reading and writing 64 

connected with school-seats 68 

Liebreich on 74 

Standing at work *3 Z 

State, duty of, in education 8-10 

Statistics of schools 15 

of spinal deformity 37 

of near-sight 57-59 

of consumption from inhal- 
ing dust 108, lc 9 



PAGE 

Statistics of accidents 133 

of length of life 142-144 

of health of factory-hands... 140 

Hirt's 142 

Farr's 143 

Steam-fan 91 

heating 87 

Stone-cutters no 

Stoves 87,88 

Strain, emotional, upon pupils... 14 

mental 15 

Study before breakfast 20 

■ in the afternoon 21 

antagonism between study 

and meals 21, 23 

interval between study and 

meals 20 

amount of. 28-33 

excess. See Over-study 28 

modern methods 29 

in kindergartens 29, 33 

Chadwick on 29, 31 

wholesome 12 

capacity for, at different 

ages 29-32 

maximum average 31 

at West Point 31 

in colleges 32 

in high-schools 32 

by the half-time system 32 

in kindergartens 33 

in primary schools 33 

with occasional rest of eyes.. 54 

recesses in 62 

See Education, Girls, Men- 
tal. 
Sulphate of quinia, manufacture 

of. 115 

Sulphuretted hydrogen 123 

Sulphurous acid produced by 

burning gas 83 

Sunlight in rooms 83 

inschools 94 

Tailors 129, 131 

Teachers, walking exercise 35 

Sabbath rest for .". 35 

of gymnastics, dearth of. 40 

iii London 41 

in Frankfort 42 

special requirements 

for 45 

for colleges 103 



152 



INDEX. 



PAGE 

Telegraph operators 129 

Temperature of room 93 

Theories of education 7-13 

Tinting of walls 83 

Tobacco 117 

Trades, duration of life in... 142-144 

Type 56, 57 

Type-founders 114 

Type-setters 129 

Type-writing machine 130 

Urinals for schools 96 

Valves for furnace 86 

Varicose veins 132 

Varrentrapp on size of school- 
room 79 

Ventilation and heating 85-93 

of closets 84 

quality of air 86 

by furnaces 86 

by radiation 87 

by steam and hot water 87 

by stoves 87 

auxiliary use of stove-funnel 88 

by fireplace 88 

— amount required 89 

expense of. 90 

by fan 90 

by windows 91, 92 

in private schools 98 

of workshops 109, 118 

of mines 123, 124 

Violinists 129 

Walking 34 

for women 34, 35 



PAG? 

Walking for scholars 101 

for teachers 34 

Wall-papers 84 

Walls, tint of. 83 

Washing, to protect from dust... 118 

Water-closets for schools 96 

Water-supply for furnaces 87 

Water, heating by 87 

Watson , Wm,, on accidents 133 

Weakness of eyes after fevers.... 52 

West Point, study at 31 

White-damp 123 

Windows 80-82 

should be on one side of room 80 

illuminating power 80 

position .. 81 

elevation 81 

collective size 82 

shades 82 

ventilation by 91 

■ in private houses 98 

Women, exercise for 34, 35 

■ — — special susceptibility to poi- 
son 116-118 

legal restraint on labor 

"8, 134, 137-139 

standing in shops 132 

Woodbury's pen-holder 129 

Work, proper amount of mental . 10 

Worry of mind 123 

Wrist-drop 115 

Writer's cramp 128, 129 

Writing as connected with 

crooked spine 37 

large hand 57 

position ia 64, 68, 70 

See Desks. 

Zwez on size of school-room 79 



THE END. 



Catalogue No. 5. FEBRUARY, 1896. 



BOOKS m NURSES. 



FOR NURSES AND ALL ENGAGED 
IN ATTENDANCE UPON THE SICK, 
OR THE CARE OF CHILDREN. 



Dealing exclusively in books on medicine 
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MEDICAL AND SURGICAL. 



A complete Text-Book for Nurses, including General Anatomy 
and Physiology, Management of the Sick-Room, Appliances used 
in Sick-Room, Antiseptic Treatment, Bandaging, Cooking for 
Invalids, etc., etc. 

Thirteenth Edition. With 70 Illustrations. 

BY LAWRENCE HUMPHREY, M.A., M.D. 

12MO. CLOTH. PRICE $1.00. 



St. Joseph's Hospital, 

Seventeenth and Girard Avenue, 

Philadelphia, March 15, 1393. 
Messrs P. Blakhton, Son &* Co. : — 

Please send us six more copies of Manual of Nursing, by Humphrey. We 
do not know of any book that more completely meets the requirements of a 
Training Class than Dr. Humphrey's able Lectures, for they are at once clear, 
concise, and thoroughly practical. Sisters of Charity. 



From British Medical Journal, London. 

11 Nursing literature is expanding, and, what is more to the purpose, it shows 
manifold signs of improvement with its growth. In the fullest sense, Dr. 
Humphrey's book is a distinct advance on all previous manuals. It is, in point 
of fact, a concise treatise on medicine and surgery for the beginner, incorporat- 
ing with the text the management of childbed and the hygiene of the sick-room. 
Its value is greatly enhanced by copious wood-cuts and diagrams of the bones 
and internal organs, by many illustrations of the art of bandaging, by tempera- 
ture charts indicative of the course of some of the most characteristic diseases, 
and by a goodly array of sick-room appliances, with which every nurse should 
endeavor to become acquainted. . . . The systematic arrangement of 

subjects adopted by the author is excellent." 



THE BEST GENERAL TEXT-BOOK. 



NURSING IN 

ABDOMINAL SURGERY 

AND 

DISEASES OF WOMEN. 

A Series of Lectures Delivered to the Pupils of the Training School 

for Nurses Connected with the Woman's Hospital of 

Philadelphia, comprising their Regular Course 

of Instruction on such Topics. 

BY ANNA M. FULLERTON, M.D., 

Physician-in-Charge of and Obstetrician and Gynaecologist to the IVoman's 
Hospital of Philadelphia, etc. 

SECOND EDITION, REVISED. 

12mo. 300 Pages. 70 Illustrations. Cloth, $1.50. 

***The immediate success of Dr. Fullerton's " Handbook of 
Obstetric Nursing,'' a fourth edition of which has just been pub- 
lished, has encouraged her to prepare this manual on another and 
very important branch of the science and art of nursing. Dr. 
Fullerton has demonstrated that she nol only knows what to say, 
but that she has the happy faculty of saying it in a plain, practical 
style that interests as well as instructs. 

Synopsis of Contents. — The Surgical Nurse — The Germ Theory 
of Disease — Asepsis and Antisepsis — Abdominal Section — The Pre- 
paration of the Room — The Preparation of Sponges — Sterilization 
of Instruments, etc. — Preparation of the Patient — Preparation of 
Operator and Assistants — The Nurse's Duties During Operation — 
The Nurse's Duties After Operation and During Convalescence — 
Management of Complications — The Pelvic Organs in Women — 
Diseases of Women — General Nursing in Pelvic Diseases — Pre- 
parations for Gynaecological Examinations — Preparation for Gynae- 
cological Operations— Preparation of Patient, Operator and Assist- 
ants — Duties of Nurse During Operation — Special Nursing in 
Gynaecological Operations — Diet for the Sick — Supporting Treat- 
ment of Abdominal Sections — Index. 



A HANDBOOK 

OBSTETRIC NURSING. 

Comprising the Course of Instruction in Obstetric Nursing 

given to the Pupils of the Training School for Nurses 

connected with the Woman's Hospital of Philadelphia. 

BY ANNA M. FULLERTON. M.D., 

Demonstrator of Obstetrics in the Woman's Medical College of Pennsyl- 
vania: 1'hys cim-in- Charge and Obstetrician and Gynecologist to the 
Woman's Hospital of Philadelphia, and Superintendent of the 
Nurse Training School of the Woman' s Hospital of Philadelphia. 

40 Illustrations. 12mo. Handsome Cloth, $1.00. 
FO UR TH EDITION— RE VISED. 

Synopsis of Contents —The Pelvis and Genital Organs- 
Signs of Pregnancy — Management of Pregnancy— Accidents of 
Pregnancy — Germs and Antisepsis— Application of Antisepsis to 
Confinement Nursing — Preparations for the Labor — Signs of 
Approaching Labor and the Process of Labor — Duties of the Nurse 
during Labor— Accidents and Emergencies of Labor— Care of the 
New-born Infant — Management of the Lying-in — Characteristics of 
Infancy in Health and Disease — The Ailments of Early Infancy — 
Index. 

" It is a book that I have recommended since I first saw it, and we are using 
it for our nurses at the N. Y. Infirmary, wheie we have a branch of our School, 
our nurses going there for instruction in obstetrics." — Mrs. L. W. Quintard] 
Supt. Connecticut Training School for Nurses, New Haven, Conn. 

"It is the most modern and complete book I have ever read for the care of 
obstetrical patients. I shall take pleasure in recommending it to this school for 
study."— E. L. Warr, Supt. Training School for Nurses, City Hospital, St. 
Louis, Mo. 

" I have looked it over and read it with care, and think it is the best book I 
have ever seen on the subject. It is practical, with plain instructions, nothing 
superfluous. A good book for nurses and teachers of nurses." — Miss Anna 
G. Clement, Supt. of Nurses, The Henry W. Bishop Memorial Training 
School for Nurses, Pittsfield, Mass. 

" I consider the book excellent in every particular. Would recommend it to 
every nurse, whether she did obstetrical nursing or not." — Gertrude Mont- 
port, Supt of Nurses, Nezv England Hospital for Women and Children, 
Boston, Mass. 

" What is to be learned in a maternity training school is the way to nurse as a 
profession. * * * Can recommend it as a valuable manual." — From the Amer* 
ican Journal of Medical Sciences. 



BOOKS ON NURSING. 



VOSWINKEL. Surgical Nursing, a Manual for 
Nurses and Students, including Complete Chapters 
on Bandaging, Dressings, Splints, etc. By Bertha 
M. Voswinkel, Graduate of the Episcopal Hospital, 
Philadelphia; Nurse in Charge of Children's Hos- 
pital, Columbus, Ohio. With in Illustrations. 121110. 
168 pages. Cloth, $1.00 

SHAWE. Notes for Visiting Nurses, and all 

those Interested in the Working and Organization of 
District, Visiting, or Parochial Nurse Societies. By 
Rosalind Gillette Shawe, District Nurse for the 
Brooklyn Red Cross Society. With an Appendix 
explaining the Organization and Workings of various 
Visiting and District Nurse Societies, by Helen C. 
Jenks, of Philadelphia, nmo. Cloth, $1.00 

CULLINGWORTH. A Manual of Nursing, 
Medical and Surgical. By Charles J. Cul- 
lingworth, m.d., Physician to St. Mary's Hospital, 
Manchester, England. Third Edition. With 18 
Illustrations. j2mo. Cloth, .75 

by the same author. 

A Manual for Monthly Nurses. Third Edi- 
tion. 321T10. Cloth, .40 

"This small volume is written as a supplement to the author's well-known 
work on nursing. It treats only of the conditions of pregnancy and labor. It 
is clear in its statements, and will prove of great value to those whose duty it 
is to care for women during and after confinement." — N. Y. Medical Journal. 

DOMVILLE. Manual for Nurses and Others 
Engaged in Attending to the Sick. By Ed. J. Dom- 
ville, m.d. Seventh Edition. With Directions for 
Bandaging, Preparing and Administering Enemata, 
Fomentations, Poultices, Baths, etc., Recipes for 
Sick-room Cookery, Tables of Weights, and a Com- 
plete Glossary of Medical Terms. Cloth, . 75 



BOOKS ON NURSING. 



CANFIELD. The Hygiene of the Sick-Room. 

A Book for Nurses and Others, being a Brief Consid- 
eration of Asepsis, Disinfection, Bacteriology, Im- 
munity, Heating and Ventilation, and Kindred Sub- 
jects, for the use of Nurses and Other Intelligent 
Women. By Wm. Buckingham Canfield, a.m., 
m.d., Lecturer on Clinical Medicine, and Chief of 
Chest Clinic, University of Maryland, Visiting Phy- 
sician to Bay View Hospital, etc. i2mo. 247 pages. 
Handsome Cloth Binding, #1.25 

*#* This book is the outcome of a series of lectures delivered by 
Dr. Canfield at the University of Maryland Training School for 
Nurses. It contains much valuable information not included in the 
regular text-books, but which of necessity the nurse should be ac- 
quainted with. 

" We recommend it to the attention, not only of sick-nurses, but also all other 
persons, of either sex, who desire a knowledge of the behavior of disease, as it 
concerns infection ; and the manner in which foulness, either of wounded sur- 
faces, or of the sick-room, or of the dwelling-house, may be prevented. 

" Each disease is taken up in turn (typhoid fever, consumption, diphtheria, 
etc.) and the methods of management of the discharges, etc , are described in 
detail. The formulae for the preparation of disinfecting solutions, for clothing, 
utensils, privies, etc., are clearly set forth; such details as one may search his 
library in vain for are here given in a compact form. 

" The prevention of blindness in infants receives lull attention. Ventilation 
is duly considered, and a chapter is given to the thoughtful discussion of immu- 
nity and protection from disease. The book closes with some remarks upon 
the diet of the sick-room. We congratulate Dr. Canfield on his work. It is 
well worth the moderate price.'' — Maryland Medical Journal. 

GRAPHIC CLINICAL CHART. Designed by 
J. P. Crozer Griffith, m.d. The purpose of this 
chart is to give, in the most concise form, a complete 
record of pulse, respiration, and temperature of the 
patient. Its simplicity and the ease with which it is 
kept commend it to nurses, and the clearness of the 
design makes plain at a glance the full history of the 
case. Price, in packets of 50, .50 



BOOKS ON MASSAGE. 



KLEEN. Handbook of Massage. Cloth, $2. 25 
By Dr. Kleen, of Stockholm and Carlsbad. Translated 
by Edward M. Hartwell, a.m. m.d., Director of Physi- 
cal Education, Boston Public Schools, late of Johns Hop- 
kins University, Baltimore. With an introduction by S. 
Weir Mitchell, m.d., of Philadelphia. Illustrated by a 
series of Handsome Engravings, made from fine Pen-and- 
ink Drawings after original photographs made for the pur- 
pose. *** This is the American Edition of "Kleen's Hand- 
book,'' which is well known among teachers and experts 
as the most comprehensive and perfect on the subject. 
Several changes and additions have been made at the 
author's suggestion, notably among the latter the set of 
illustrations made from photographs taken by him for this 
edition. No pains have been spared to make this the best 
of standard works upon massage. 

MURRELL. Massotherapeutics. Fourth Edi- 
tion. Or Massage as a Mode of Treatment. By Wm. 
Murrell, m.d., f.r.c.p., Lecturer on Pharmacology and 
Therapeutics at Westminster Hospital, Examiner at Uni- 
versity of Edinburgh, Physician to Royal Hospital for Dis- 
eases of the Chest. Fifth Edition. Revised and Enlarged. 
Illustrated. i2mo. Cloth, 1.25 

" Dr. Murrell particularly dwells on the importance of discrimination in the 
selection of cases and on the special qualifications of a competent manipulator. 
In a word, this essay may be said to convey in a short space most of the infor- 
mation that is at present available in regard to this popular therapeutic agent. " 
— From the London Practitioner. 

" This little volume sets forth clearly all the advantages and disadvantages 
of massage at the present day, and should be in the hands of every Masseuse 
or nurse intending to take up the art. The numerous illustrations of the move- 
ments will prove a great aid. " — From the Trained Nurse . 



OSTROM ON MASSAGE. 



THIRD EDITION. 



Massage and the Original Swedish Move- 
ments. Illustrated. And Their Application to 
Various Diseases of the Body. A Manual for Students, 
Nurses, and Physicians. By Kurre W. Ostrom, 
from the Royal University of Upsala, Sweden ; In- 
structor in Massage and Swedish Movements in the 
Hospital of the University of Pennsylvania and in 
the Philadelphia Polyclinic and College for Graduates 
in Medicine, etc. Illustrated by ninety-three ex- 
planatory Wood Engravings. Third Edition, Revised 
and Enlarged. 121110. Cloth, $1.00 

" Mr. Ostrom presents to the English public this excellent, systematic manual, 
showing, by illustrations, the various movements and the mode of application to 
all parts of the body. The writer tells for what diseases such movements are 
indicated, with some remarks on the physiology of the movement treatment." 
— From The Philadelphia Public Ledger. 

" In this volume the author gives an excellent description of the methods of 
massage and Swedish movement, together with their applicability to various 
diseased conditions of the body. The methods are rapidly becoming popular- 
ized in our own country, and the perusal of such a book as Mr. Ostrom has 
written will be of great advantage to physicians, for whose use it is mainly in- 
tended."— From the Journal of the American Medical Association. 

4* Our author has performed a useful service in publishing this 

brief and clearly written manual, and we can recommend it to all who wish to 
gain a knowledge of a method of procedure which is daily finding more favor 
in professional circles. The price of the volume should also insure it a wide 
circulation."— From the Edinburgh Medical Journal. 

"The descriptions are clear, and so well supplemented by the illustrations, 
that anyone with this book, and a subject on which to practice, could undoubt- 
edly become proficient in the art of massage. An excellent feature is the simple 
classification of the manipulations adopted by the author, which makes the 
whole subject much easier to grasp. "—From the Medical News, Philadelphia. 



ANATOMY A ND P HYSIOLOGY. 

POTTER'S Anatomy. Fifth Edition. 117 
Illustrations and 16 Lithograph Plates. A 
Compend of Human Anatomy. By Saml. O. L. 
Potter, m.a., m.d., m.r.c.p. (Lond.), Professor of 
the Practice of Medicine, Cooper Medical College, 
San Francisco. 121110. Cloth, .80 

" This is, in its way, a wonderful little book, comprising within its pages z. 
more or less complete account of every part of the human body, not even omit- 
ting the histology of the tissues and organs." — Edinburgh Medical Journal, 

" Contains many useful hints and aids to memory not found in ordinary 
works." — Canada Lancet. 

" The arrangement is well calculated to facilitate accurate memorizing, and 
the illustrations are clear and good." — North Carolina Aledical Journal. 

BRUBAKER'S Physiology. Seventh Edition, 
Enlarged and Improved. Illustrated. A Com- 
pend of Physiology, including Embryology. By 
A. P. Brueaker, m.d., Demonstrator of Physiology 
at Jefferson Medical College ; Professor of Physiology, 
Pennsylvania College of Dental Surgery, Philadelphia. 
28 Illustrations. 121110. Cloth, .80 

" This is an admirable compend of physiology, including enough of anatomy 
to fit it especially for the use of students of medicine. It has been prepared by 
one who is fully fitted by his work as Demonstrator in the Jefferson Medical 
College, and as Professor of Physiology in the Pennsylvania College of Dental 
Surgery, and by his experience as quiz-master, to compile such a book, and it 
has proved its utility by the acceptance it has already found. Its style is 
clear and distinct, its teachings are sound, and it is well suited to the 
purpose for which it is intended." — Medical and Surgical Reporter. 



MATERIA MED1CA AND THERAPEUTICS. 



POTTER'S Materia Medica, Therapeutics, 
and Prescription Writing. Sixth Edition. 

Compend of Materia Medica, Therapeutics, and Pre- 
scription Writing. With special reference to the Phy- 
siological Action of Drugs. By Samuel O. L. Potter, 
m.a., m.d., m.r.c.p. (Lond.), late A. A. Surgeon, 
U. S. Army ; Professor of the Practice of Medicine, 
Cooper Medical College, San Francisco. i2mo. 

Cloth, .80 



BOOKS FOR NURSES. 



HORWITZ'S Surgery. Minor Surgery and 
Bandaging. Fifth Edition. 167 Illustrations. 

A Compend of Surgery, including Minor Surgery, 
Amputations, Fractures, Dislocations, Surgical Dis- 
eases, Antiseptic Rules, Formulae, etc., with Differen- 
tial Diagnosis and Treatment, and a Complete Section 
on Bandaging. By Orville Horwitz, b.s., m.d., 
Professor of Genito-Urinary Diseases; late Demonstra- 
tor of Surgery, Jefferson Medical College, etc. Fifth 
Edition. 324 pages. 121110. Cloth, .80 

*x* The new Section on Bandaging and Surgical Dress- 
ings consists of 34 Pages and 40 Illustrations. Every 
Bandage of any importance is Figured. 

WYTHE'S Dose and Symptom Book. The 

Physician's Pocket Dose and Symptom Book. Con- 
taining the Doses and Uses of all the Principal 
Articles of the Materia Medica, and Officinal Prepa- 
rations. By Joseph Wythe, a.m., m.d. Seventeenth 
Edition; revised and rewritten, containing Tables of 
Weights and Measures, Rules for Proportioning the 
Doses of Medicines, Hints on Treatment, etc. 
Cloth, .75; Leather, with Tucks and Pocket, $1.00 

WESTLAND. The Wife and Mother. A 
Medical Guide to the Care of her Health and the 
Management of her Children. By Albert West- 
land, m.d. 121110. Illustrated. Cloth, $1. 50 

From the Philadelphia Medical News. 

" A noticeable point about this little volume is the commendable absence of 
technical terms, as the author plainly states that it is for the use of ' women who 
are desirous of fulfilling their proper duties of wives and mothers.' Too often, 
in works of this class, the readers for whom they are intended are confused and 
led astray by the multiplicity of words and phrases meant rather for the prac- 
titioner than the mother. . . . Altogether the books fulfills ihe objects for 
which it was written, and will materially assist the young married woman in 
the intelligent performance of new duties." 
From the Nurse, Boston. 

" The style is easy and fascinating. It should be in the hands of every nurse 
and married women." 



NEW EDITION. 

ACCIDENTS and EMERGENCIES. 

A Manual for the treatment of Surgical and other Injuries, 
Poisoning and various Domestic Emergencies, in the absence of the 
Physician. 



By CHARLES W. DULLES, M.D., 

Surgeon to the Out-Door Department of the University and Presbyterian 
Hospitals, Philadelphia. 



Fourth Edition, Enlarged. New Illustrations. 12mo. . ■ 
ILLUSTRATED. 

SHORT LIST OF CONTENTS. 



Cloth, $1.00 



Preliminary Remarks. 
Obstructions to Respiration. 
Foreign Bodies in the Eye, Nose and 

Ear. 
Fits or Seizures. 
Injuries to the Brain. 
Effects oi Heat. 
Effects of Cold. 
Sprains. 
Dislocations. 
Fractures. 
Wounds of all kinds, including the 

bites of Dogs, Cats, Snakes, Insects, 

etc. 
Railroad and Machinery Accidents. 



Hemorrhage — Bleeding. 

Special Hemorrhages. 

Transportation of the Injured. 

Poisons and their Antidotes. 

Domestic Emergencies, includes Chol- 
era Morbus, Vomiting, Diarrhoea, 
Nervous Attacks, Earache, Tooth- 
ache, Asthmatic Attacks, Croup, 
etc., etc. 

Signs of Death. 

Supplies for Emergencies. 

The Surgical and Medicine Case, 
their contents and use, Bandaging, 
Poultices, etc. 

Index. 



*** This book should be in the possession of every head of a 
family, Nurse, Manufacturer, Police Lieutenant, Sea Captain, Hos- 
pital Steward, School Teacher, Druggist, etc. etc. 

" Several attempts have been made to prepare a volume which would serve 
as a handy manual for reference in the time of need, in the absence of a doctor, 
but none have succeeded better than the present little work. It should be in the 
hands of all officers charged with the public conveyance of passengers, to be 
read, in preparation for emergencies, and afterward to serve as a book of refer- 
ence." —North Carolina Medical Journal, 

"This little manual contains simple directions for the preliminary treatment 
of accidents to all parts of the body and of such diseases as persons are suddenly 
seized with. Without profuseness or an unintelligible vocabulary, it contains in 
a small space a deal of useful information." — New York World. 

" This is a revised and enlarged edition, with new illustrations, of the manual, 
explaining the treatment of surgical and other injuries in the absence of the phy- 
sician. The simple and practical suggestions of this little book should be known 
to every one. Accidents are constantly occurring, and a knowledge of what 
should be done in an emergency is very valuable. Such -\ handbook should be 
in every home, placed where it can always be found readily. — Boston Journal 
of Education. 



11 1 may say that Dr. E. P. Davis' Manual has proved useful to me 
in teaching obstetrics by its clearness and its many practical sugges- 
tions."— MARION E. SMITH, Chief Nurse Philadelphia Hospital. 



DAVIS. Manual of Practical Obstetrics. By 
Edward P. Davis, a.m., m.^.j Clinical Lecturer en Obstet- 
rics in the Jefferson Medical College, Professor of Obstetrics 
and Diseases of Children in the Philadelphia Polyclinic, 
Visiting Obstetrician to the Philadelphia Hospital. Second 
Edition, Enlarged. 351 pages; 150 illustrations, several 
of which are colored. Cloth, $2.00 

** I have carefully reviewed the * Manual of Obstetrics ' by Dr. E. P. Davis. 

" It is full, accurate, concise, and gracefully and clearly written. It is a most 
excellent Manual of the art it teaches." — Prof. J. Snydam Knox, Rush 
Medical College, 22jy Calumet Avenue, Chicago. 

" I have read it with interest, and consider it one of the best works on the sub- 
ject for the use of students and practitioners. " — Dr. James P. Boyd, Albany 
Medical College, Albany, N. Y. 

'* I am so well pleased with the work that I have recommended it to my class. " 
— Dr. A . L. Breysacher, Medical Department A . / U. r Little Rock, A rk. 

" I have completed my examination of it, and want to say that I think it is 
the biggest little work on the subject it has been my privilege to look over. It 
is surely a complete work, devoid of theory, replete with practice. I heartily 
commend it as a manual. " — Dr. J. R. Rathmell , Chattanooga Medical College, 
Tenn. 

" I would say that in style and character it is abreast with the most modern 
and approved methods and thought upon the subject, that for brevity it is clear, 
systematic, and concise, very suitable for the busy student during the session .it 
college, and for the busy practitioner as well. Itgives the essentials, and I shall 
take pleasure in recommending it to my students." — Dr. M. R. Mitchell, Kan- 
sas Medical College, Topeka, Kan. 

"It is especially clear and pleasing in style and the subject matter is well 
chosen. It is a good text-book. " — Dr. Clara Marshall, Philadelphia. 

" It is concise and accurate, and I cordially recommend it as admirably suited 
to the convenience of the medical student and busy practitioner. "—Dr. De 
Laskie Miller, Rush Medical College, Chicago, III. 

" I consider it a very good book. " — Pro/. A -F. A. King, National Medical 
College, Columbian University, Washington, D. C. 

" I consider it a valuable work, especially for the recent graduates who are 
entering upon the practice of obstetrics and pursuing post-graduate studies. 

" I keep my copy where I can read it, and consult its pages almost daily, and 
generally find what I want in a few lines." — Dr. P. C. Claybetg, American 
Medical College, St. Louis, Mo. 

" The book appears to me to meet the purposes for which it is written and to 
he a valuable addition to the library of the busy practitioner. " — Pro/. Randolph 
Window, University of Maryland, Baltimore, Md. 

" I am well pleased with the 'Manual of Obstetrics' by Dr. E. P. Davis, 
andean recommend the work to the profession."— Pro/. C. A. Pauly, Pulte 
Medical College, Cincinnati, O. 

" The book is a most excellent one. After careful investigation, I have no 
hesitation in cordially recommending it to anybody in need of a small manual." 
—Dr. M. D. Mann, Buffalo, N. Y. 



THE 



American Health Primers. 

EDITED BY W. W. KEEN, M.D., 

Professor of Surgery in the Jefferson Medical College, Fellow of the College 
of Physicians of Philadelphia, etc. 



12 Vols. 32mo. Attractive Cloth Binding, each 40 Cents. 



This Series of Health Primers is prepared to diffuse as widely and 
cheaply as possible, among all classes, a knowledge of the elementary facts of 
Preventive Medicine, They are intended incidentally to assist in curing dis- 
eases, and to teach people how to form correct habits of living, and take care 
of themselves, their children, employees, etc. 

I. HEARING AND HOW TO KEEP IT. With Illustrations. By Chas. 

H. Burnett, m d., of Philadelphia, Aurist to the Presbyterian Hospital. 

II. LONG LIFE AND HOW TO REACH IT. By J. G. Richardson, m d , 
of Philadelphia, late Professor of Hygiene in the University of Pennsyl- 
vania. 

III. THE SUMMER AND ITS DISEASES. By James C. Wilson, m.d , 
of Philadelphia, Professor of the Practice of Medicine, Jefferson Medical 
College. 

IV. EYESIGHT AND HOW TO CARE FOR IT. With Illustrations. By 
George C. Harlan, m d., of Philadelphia, Surgeon to the Wills (Eye) 
Hospital. 

V. THE THROAT AND THE VOICE. With Illustrations. By J. Solis 
Cohen, m.d. , of Philadelj. hia, Lecturer on Diseases of the Throat in Jef- 
ferson Medical College, ami on the Voice in the National School of Oratory. 

VI. THE WINTER AND ITS DANGERS. By Hamilton Osgood, m.d., 
of Boston, Editorial Staff Boston Medical and Surgical Journal. 

VII. THE MOUTH AND THE TEETH. With Illustrations. By J. W. 
White, m.d , d.d.s., of Philadelphia, Editor of the Dental Cosmos. 

VIII. BRAIN WORK AND OVERWORK. By H . C. Wood, Jr., m.d ., of 
Philadelphia, Clinical Professor of Nervous Diseases in the University of 
Pennsylvania. 

IX. OUR HOMES. With Illustrations. By Henry Hartshornb m.d , 
of Philadelphia, formerly Professor of Hygiene in the University of Penn- 
sylvania. 

X. THE SKIN IN HEALTH AND DISEASE. With Illustrations. By 
L. D. Bulkley, m.d., of New York, Physician to the Skin Department 
of the New York Hospital. 

XI. SEA AIR AND SEA BATHING. With Illustrations. By John H. 
Packard, m.d., of Philadelphia, Surgeon to the Pennsylvania Hospital. 

XII. SCHOOL AND INDUSTRIAL HYGIENE. By D. F. Lincoln, m.d., 
of Boston, Mass., Chairman Department of Health, American Social 
Science Association. 

" The series of 'American Health Primers" deserves hearty commendation. 
These handbooks of practical suggestions are prepared by men whose profes- 
sional competence is beyond question, and, for the most part, by those who 
have made the subject treated the study of their lives." — Ne7u York Sun. 

*>* Each Volume 50 Cents, in Attractive Cloth Binding. 



BYFORD'S 
MANUAL OF GYNECOLOGY 

Two Hundred and Thirty-four Illustrations. 

By Henry T. Byford, m.d., Professor of Gynecology 
and Clinical Gynecology in the College of Physicians 
and Surgeons of Chicago ; Professor of Clinical Gyne- 
cology in Woman's Medical School of Northwestern 
University, etc. 

12mo. 488 Pages. Cloth, $2.50. 



Though prepared more especially for medical stu- 
dents and young physicians, this book has many 
points that recommend it to the nurse who wants 
to thoroughly understand the important details of 
gynecological nursing. 

The chapters in Part One on gynecological tech- 
nique and the principles of gynecological treat- 
ment are more minute in detail than is usual in 
such books, special attention being given to the 
duties of the nurse, to aseptic and antiseptic mat- 
ters, instruments, etc., etc. A series of eight illus- 
trations showing the various postures in which the 
patient is placed for examination or operating will 
prove 



GOULD'S POCKET MEDICAL LEXICON. 



12,000 MEDICAL WORDS 

PRONOUNCED AND DEFINED. 

A Pronouncing Lexicon of Medical Words Specially Adapted for 
Nurses, Including Many Useful Tables and a Dose List. 

BY GEORGE M. GOULD, M.D., 

Author 0/ "An Illustrated Dictionary of Medicine, Biology, and Allied 
Sciences," " The Student's Medical Dictionary," etc. 

Pocket Size. 317 Pages. Gilt Edges, Full Morocco. 
Price $1.00; with a Thumb Index, $1.25. 



OVER 47,000 COPIES OF GOULD'S DICTIONARIES 
HAVE BEEN SOLD. 



" Gould's Dictionary, Pocket Edition, is the most complete and convenient I 
have seen." — Marion E. Smith, Head Nunc, Philadelphia Hospital, Phila. 

"The Pocket Dictionary is a little gem." — L J. Gross, Head Nurse , Buffalo 
General Hospital. 

" I have examined Gould';. Dictionary, and consider it the best dictionary in 
a small compass that I have seen. The price, too, is most reasonable I shall 
recommend it to all our nurses." — F. Hutcheson, J lead Nurse, Flower Mission 
Training School for Nurses, Indianapolis, Ind. 

" 1 shall certainly have the nurses each send for a copy of the dictionary. It 
is just what they need, and is a nice size to carry. " — Harriet Sutherland, Head 
Nurse, Margaret Pillsbury Hospital, Concord, N. H 



#5" Every nurse should have a copy of this little book in order 
to intelligently pursue her studies and to thoroughly understand 
the physician's directions. It fur n'^immmm^mmgmmmmm^^l inform a 
tion not to be obtained in the res<;lar text-books. ^^V^ 





Date 


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Llbrao Bureau Cat. No. 1137